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Administration takes case for Obamacare directly to Texans

Secretary Burwell met with the Gulf Coast Collaborative including Texans Together prior to the press conference.  She discussed the importance of the organizations involved in reaching the goal for Texas.  She said they had a million people log into the healthcare marketplace over the previous weekend and the call center fielded over 200,000 calls with 20,000 going to Spanish speaking representatives. She stressed Latino Outreach was key to success in Texas.

The following article was originally written by Lori Hines , for the November 18, 2014 Houston Chronicle 

Photo by James Nielson/Houston Chronicle

As the second enrollment period for its federally mandated health insurance program gets under way, the Obama administration is bypassing Texas leaders intractably opposed to the Affordable Care Act and working directly with more cooperative local officials and grass-roots organizations.

Without committing to a specific numerical goal for Texas, Health and Human Services Secretary Sylvia Burwell said Tuesday in Houston that she plans to make repeated trips to and across the state to meet with organizers and to hold substantive health-care conversations with uninsured Texans about the importance of insurance and the subsidies that will cut premium costs for most of those who now lack insurance.

Burwell, the administration official charged with getting Americans signed up for coverage, vowed to cut through headlines and political rhetoric to give people information they need. Open enrollment began Saturday and lasts through Feb. 15.

"I think the substance of the issues will prevail as we go through this time," Burwell said.

Texas has the most and the highest rate of uninsured residents in the U.S. despite getting about 734,000 people signed up during the inaugural enrollment for 2014. While that signup period was plagued with problems initially, the program wound up enrolling more than 8 million Americans overall and it included a late push in Texas by Burwell's predecessor.

With some 6 million Texans still uninsured, Burwell's early appearance this go-round shows a renewed fight to increase the health care law's impact in Texas, where the governor's office has refused to create a state-run marketplace or accept billions of dollars in federal funding to expand Medicaid to extend coverage to millions more people.

State and local organizers say the first insurance sign-up period helped them become more organized and strategic as they prepared for the 2015 open enrollment period.

They intend to hold multiple enrollment events, provide additional one-on-one application assistance opportunities and include more grass roots organizations and community leaders in educating the uninsured about marketplace coverage. They have data showing where the uninsured live. The key is deploying the appropriate organizations and people to reach target areas and groups, including Hispanics and young people.

"We learned about the importance of follow-up and the need for a lot of outreach," said Mimi Garcia, the Texas state director for Enroll America, a national insurance advocacy organization. "There's a lot of work to do in Houston. That's going to be a big focus area."

Organizers learned from last year's open enrollment that the more conversations they have with uninsured residents, the more likely they are to convince someone to buy health coverage, Garcia said by telephone from a conference in New Orleans. She said the goal is for people to view purchasing health insurance as routine a practice as paying taxes or auto insurance.

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Burwell's appearance at a news conference at the Denver Harbor Multi-Service Center, which includes a community health clinic and serves as health insurance marketplace enrollment center on the east side, followed a meeting held by the Gulf Coast Health Insurance Marketplace Collaborative.

That group was organized to enroll more than 1 million uninsured residents, many of whom are low-income and Hispanic, in the 13-county Houston area.

Unlike the first health insurance enrollment period mandated by the health care law, Burwell said this time around there are thousands of success stories to share, proving marketplace coverage works and is affordable. She wants to put a spotlight on those people to motivate others to participate. Although she mentioned the federal penalty for those failing to purchase coverage, she remained focused on three main talking points: "Quality, access and affordability."

"That's what the conversation's about," she said. "And that's what most Americans care about."

Burwell then introduced Davis Ortez, a 29-year-old Houston attorney who bought 2014 marketplace coverage, paying a $146 monthly premium. It's at least the second time Ortez has told his insurance story since last week, when he spoke at another Houston news conference.

The state's uninsured rate dropped about 2 percent this year, but Elena Marks, president and CEO of Houston's Episcopal Health Foundation, a philanthropy that will fund health care providers, said many Texans gained employer-based insurance as the economy created more jobs.

In comparison, California's uninsured rate dropped nearly in half, from 22 percent to a little less than 12 percent, in large part to the state's decision to expand Medicaid coverage to cover more of its low-income, working residents.

Marks said it makes sense for Burwell and other officials to bypass Texas' political leadership and instead work with local governments, agencies and organizations, including those in the Houston area, to find the uninsured and enroll them in health coverage.

"Having her show up brings attention to the issue," said Marks, who also is a non-resident health care fellow at Rice University's Baker Institute.

Marks, who did not attend Burwell's news conference, said new carriers are making the Texas marketplace more competitive this year.

Risha Jones, deputy director of Houston's Department of Health and Human Services, said her agency's goal is to directly contact 100,000 uninsured residents and reach another 400,000 through community and educational outreach. She said federal officials recognize the Houston area needs assistance in reaching its uninsured residents and has pledged to help. They haven't yet set an enrollment goal.

"They are making us a priority," Jones said, who introduced Burwell at the news conference. "We're on the radar."

On their way out after Burwell's appearance, dozens of community leaders walked past Mary Sidney, who was waiting for an eye exam at the Multi-Service Center.

Sidney, 65, said she bought marketplace coverage this year because she did not want to pay the federal penalty. Like many people, she bought the least expensive coverage she could find.

"It's good and it has drawbacks," she said.

At $42 a month, her premium seems reasonable, but her $6,000 deductible makes her plan unaffordable. Meanwhile, her premium will more than double to $98 in 2015, forcing Sidney, who works at a church, to look for an alternative that allows her to keep her doctor.

"I'm praying for the little bit of health I have," she said. "I got my plan so I wouldn't be penalized. I was trying to stay out of trouble."

Administration takes case for Obamacare directly to Texans

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