Two high-profile Texans are fighting the Affordable Care Act.
Gov. Rick Perry has loudly dismissed the law, and fellow Republican Sen. Ted Cruz took to the Senate floor this week to rail against it at length — 21 hours and 19 minutes to be exact.
On the other side of the issue, you have Rosy Mota and her clipboard, standing at the door of a CVS pharmacy in one of Houston's Latino neighborhoods, stopping shoppers.
"Hello, would you like a brochure about the new health care coverage that's coming into effect? We'll be here if you have any questions," she tells a customer.
Mota works for Enroll America, a national organization that has borrowed its tactics from the Obama re-election campaign. The group has combined sophisticated data-mining techniques and digital maps to figure out where the uninsured in Houston live, down to the block and house level.
Enroll America has just seven workers for Houston's 800,000 uninsured residents. But it is part of a coalition of organizations that includes the city health department, the county's public clinics, and groups like the Urban League. They're all trying to get the word out about health insurance marketplaces and help the uninsured buy coverage made possible by the health law. The exchanges are scheduled to open Oct. 1.
"Regardless of whether you are for the Affordable Care Act or you're against the Affordable Care Act, we're not looking at it that way," says Houston health official Benjamin Hernandez. "We're saying that, from a public health perspective, getting people insured and getting them into the system is a good thing to do."
The state of Texas is not providing any money or staff to help people sign up. So the city is using federal money funneled through the United Way and also tapping its own resources.
In fact, it considers the project so important that it's using the same command-and-control structure that it uses during hurricanes. Instead of shelters and relief centers, the city is compiling a list of block parties, church events and festivals where people can learn about how to sign up for Obamacare.
In addition to uninsured whites, black and Latinos, Houston has large populations of immigrants from Vietnam, China and South Asia. Last week Asian-American health advocates met with the city health director and a Medicare official. They shared concerns about people's lack of information and trouble finding interpreters.
Denise Truong, program director at the Chinese Community Center, described problems she had with the government's 800 number, which is supposed to offer interpreters in 150 languages. "First, either we can't reach an interpreter and the phone is hung up, or we reach an interpreter and ... the interpreter isn't qualified to answer questions about the marketplace," she said.
Michael Coulter, the Medicare representative, said there have been problems with the interpreters, but they're getting fixed and urged the groups to keep trying.
With almost 2.6 million Texans eligible to enroll in the marketplaces, Coulter said, the scope of the enrollment will be historic.
Rosy Mota is working with those Texans one at a time at the CVS. She catches customer Maribel Hernandez's attention by telling her that everything will be explained to her clearly. "There's, like, no more fine print," Mota says. "It's, like, plain."
Hernandez is 38. Her family has insurance, but she's unhappy with the coverage. Mota tells her she might find a better deal in the marketplace.
Another one of Hernandez's concerns is her diabetes. "It is pre-existing, so will they deny you because of that?" she asked.
"No, ma'am," Mota answers. "They are prohibited by law now. ... And they cannot charge you more either."
"Good," Hernandez responds, "because that's one of my main things."
DAVID GREENE, HOST:
And let's hear more about the health care law at the center of that debate on Capitol Hill. A key part of Obamacare is scheduled to begin on Tuesday. This is when marketplaces are set to open in every state, offering a menu of health plans.
In Texas, the marketplace could have a big impact. That's because almost one in four Texans are uninsured, and local health care reform advocates are worried that there hasn't been enough education about the law's details. They're racing to bring Texans up to speed before enrollment next week.
From member station KUHF in Houston, Carrie Feibel reports.
CARRIE FEIBEL, BYLINE: Some states have taken an active roll in getting the word out, using clever TV ads to promote their marketplaces. But Texans are more likely to turn on their TVs and hear this.
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SENATOR TED CRUZ: There's bipartisan agreement that Obamacare isn't working.
FEIBEL: That's Texas Senator Ted Cruz, who's been a leading opponent of Obamacare in Congress. On the other side, you have Rosy Mota and her clipboard. She stands at the door of a CVS pharmacy in one of Houston's Latino neighborhoods.
ROSY MOTA: Hello.
UNIDENTIFIED WOMAN: Hi, there.
MOTA: Like a brochure about the new healthcare coverage that's coming into effect? We'll be here if you have any questions.
FEIBEL: Mota is just one of seven Houston-based outreach workers with the group Enroll America. It's a national organization, and it's using data mining and digital maps to figure out where the 800,000 uninsured people in Houston actually live. Their goal is to find them and persuade them to sign up. Mota tells on customer, Maribel Hernandez, that it will be very easy to do.
MOTA: And all plans have to explain everything to you in plain English. There's, like, no fine print. It's, like, plain.
FEIBEL: Hernandez is 38. Her family does have insurance, but she's really unhappy with the coverage. Mota tells her that she might find a better deal in the marketplace. Hernandez has diabetes, though, so she asks about that right away.
MARIBEL HERNANDEZ: What about diabetes? Is that considered a preexisting condition?
MOTA: Yes, yes.
HERNANDEZ: It is a preexisting. So, will they deny you because of that?
MOTA: No, ma'am. They are prohibited by law.
HERNANDEZ: Well, good.
MOTA: Yes, they are. They cannot charge you more, either.
FEIBEL: Enroll America is joining forces with others, like the city health department, the country's public clinics and groups like the Urban League. Benjamin Hernandez is a Houston health official. He says the city has spent months getting ready for October 1st.
BENJAMIN HERNANDEZ: Regardless if you are for the Affordable Care Act or you're against the Affordable Care Act, we're not looking it that way. We're saying that from a public health perspective, getting people insured and getting them into the system is a good thing to do.
FEIBEL: The state of Texas is not providing any money or staff to help people sign up. So the city is using federal money, funneled through the United Way, and also tapping its own resources. In fact, it considers the project so important that it's using the same command-and-control structure it uses during hurricanes. But instead of shelters and relief centers, the city is compiling a new list of block parties, church events and festivals where people can learn about Obamacare.
HERNANDEZ: When you look at Harris County, we've got close to about a million uninsured people. So there's a lot to go around. So, that's why we want to organize, so we make sure we get to all the different pockets in the county that need to hear about this.
FEIBEL: Getting to all those pockets will be difficult. In addition to whites, blacks and Latinos, there are large populations of people from Vietnam, China and South Asia. Last week, Asian-American health advocates had a meeting with the city health director and a federal official. Mahmood Marfani, a Pakistani-American, volunteers at a charity health clinic.
MAHMOOD MARFANI: I see, every day, a lot of people, and they don't have the information. Similarly, small businesses have the same problems.
FEIBEL: Denise Truong is the program director at the Chinese Community Center. She's had trouble with the government's 800 number, which is supposed to offer interpreters in 150 languages.
DENISE TRUONG: Either we can't reach an interpreter and the phone is hung up, or we reach an interpreter, and the interpreter is not qualified to answer questions about the marketplace.
FEIBEL: The federal officials said there have been problems with the translation service, but they're working on it. Almost 2.6 million Texans are eligible to enroll in the marketplace, but with Governor Perry completely opposed to the law, the task will fall on the cities, local groups and clinics to find and enroll those people one conversation at a time. For NPR News, I'm Carrie Feibel, in Houston.
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GREENE: And Carrie's story was part of a collaboration with NPR, KUHF and Kaiser Health News. Transcript provided by NPR, Copyright NPR.