As Obamacare Deadline Approaches, Texas Officials Push For Enrollment

Dallas resident Edna Pemberton, 68, received a devastating cancer diagnosis in January 2012. To make matters worse, she discovered she had not properly signed up for Medicare.

Her oversight inspired her to become a warrior for the Affordable Care Act. She is one of 220 Dallas-Fort Worth Enroll America volunteers trying to nudge local residents to sign up on the insurance exchanges, and had the honor of introducing President Obama when he spoke to Dallas volunteers in November.

Enroll America, the nation’s leading non-profit health insurance enrollment organization, is planning a volunteer-training blitz Saturday in Dallas and Houston to cut the state’s uninsured rate before the March 31 exchange sign-up deadline. With time running short, the organization is focusing its efforts on major population areas with the greatest numbers of uninsured.

The Obama administration also is focusing its exchange-outreach efforts on 25 major metropolitan areas. Dallas and Houston are among the top five on that list. Federal officials predict a surge of applications just before the deadline.

A survey by healthcare research firm PerryUndem found that 8 out of 10 uninsured Americans said they would sign up for insurance if they could find an affordable plan. The survey underscored that lack of awareness of subsidies—not website problems—was the main barrier to exchange enrollment.

Enroll America state director Mimi Garcia said some still believe Texas is exempt from the ACA. “We are looking for people to make phone calls, man tables at grocery stores, and host gatherings in their homes. We’re looking for anyone who wants to get word out,” she said.

Garcia said Saturday’s effort is part of a nationwide campaign. Besides Dallas and Houston, training will be held in Austin, El Paso, San Antonio, and Edinburgh.

Daniel Davis Clayton, North Texas regional organizing leader, said Enroll America has six paid organizers in DFW, two of which are bilingual. He said the best volunteer organizers are those who have personal experience with securing insurance through the exchanges.

“They have seen family members get sick and die because they didn’t have affordable care,” he said. “Or they didn’t go to the hospital because they didn’t want to be a financial burden their families.”

Clayton said organizers want to hold outreach meetings at community venues such as churches and recreation centers to reach more people at once.

The organization has also altered its message to emphasize insurance subsidies.

“[Subsidies] are the number one thing that really demonstrates to consumers that something is different about the insurance market and it’s worth checking out,” Enroll America president Anne Filipic told The Washington Post last week. “It needs to be the lead point, instead of one of four or five points. We’ve made it our top messaging point. In our field scripts, it was something we were talking about, but it often wasn’t the first thing, so we changed that.”

Enroll America and a coalition of eight other national organizations are planning enrollment efforts specifically for Hispanics in Dallas March 1. Dallas, which was a pilot location for an Hispanic outreach even, successfully enrolled hundreds on Jan. 25. The coalition plans a 15-city campaign through the end of March in metropolitan areas with large concentrations of Hispanics. According to the U.S. Department of Health and Human Services, 8 out of 10 Hispanics could be eligible for financial assistance, Medicaid or the Children’s Health Insurance Program through the exchanges.

Enroll America volunteers cannot assist people in signing up for insurance. Exchange customers are directed to either local navigators or certified application counselors.

The group raised more than $27 million in 2013 and built a national grassroots field program in 10 target states, including Texas. The staff grew from 14 to about 200 employees, and has attracted more than 10,000 volunteers and 260 partner organizations.

Signup efforts have been hampered locally by a number of factors. Texas did not expand Medicaid to cover most poor adults and the state’s large population of illegal immigrants are not eligible for coverage on the exchange.

Enrollment in the health exchange has grown by 75 percent since the end of December, according to HHS officials. January signups exceeded the enrollment target for the first time since enrollment began in October. However, cumulative enrollment is about 1 million short of earlier projections because the botched website launch in October and November.

More than 207,000 Texans have enrolled on the federally facilitated exchanges. Of those, nearly 8 out of 10 were eligible for subsidies. Another 80,000 who inquired about the exchange plans discovered they were eligible for Medicaid or the Children’s Health Insurance Plan.

Texas’ performance was considered below standard. Signups were only 53 percent of the state’s target, compared with the national rate of 75 percent.

The latest Gallup Poll showed a decline in the nation’s uninsured rate to 16 percent, the lowest level since 2009. It is unclear how much the health exchanges contributed to the decrease.

According to an Associated Press analysis based on 2011 census date, half of the nation’s uninsured live in less than 4 percent of the country’s counties. Dallas, Tarrant, Collin, and Denton counties are among those counties with the highest rates. One out of four Texans lack health insurance.

To participate in the enrollment training, call (972) 345-4591 or RSVP here.

Steve Jacob is editor-at-large of D Healthcare Daily and author of the book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at steve.jacob@dmagazine.com.

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