ABSTRACT

This qualitative study addresses the experiences of paid professionals and volunteers who worked through nonprofit human service organizations to help people obtain health insurance in the first wave of open enrollment for the Patient Protection and Affordable Care Act (ACA). Focusing on the state of Alabama, we compare and contrast the experiences of ACA navigators in different settings: (1) established nonprofits that received federal contracts to provide navigation services, and (2) a new nonprofit started specifically to help people sign up for ACA coverage. Findings contribute to the policy implementation literature by illuminating how policy implementation in different nonprofit settings can result in varying experiences of personal and political transformation. Findings contribute to the policy feedback literature by illustrating the potential for policy feedback effects on frontline workers. The study also illustrates again that human services nonprofits can create organizational conditions to promote empathy, excitement, and dedication at the frontlines.

摘要

这项定性研究探讨了付费专业人士和志愿者的经验，他们通过非营利性人类服务组织帮助人们在第一波《患者保护和平价医疗法案》(ACA) 的公开招生中获得健康保险。以阿拉巴马州为重点，我们比较和对比了 ACA 导航员在不同环境中的经验：(1) 已建立的非营利组织获得联邦合同以提供导航服务，以及 (2) 一个新的非营利组织开始专门帮助人们注册 ACA覆盖范围。通过阐明不同非营利环境中的政策实施如何导致个人和政治转型的不同经历，研究结果有助于政策实施文献。研究结果通过说明政策反馈对一线工人的潜在影响，有助于政策反馈文献。该研究还再次表明，人性化服务非营利组织可以创造组织条件，以促进一线的同理心、兴奋和奉献精神。