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Houston Gears Up For Obamacare, Despite GOP Opposition

Enroll America outreach worker Rosy Mota (right) talks about the federal health care law with a CVS customer.
Carrie Feibel
Enroll America outreach worker Rosy Mota (right) talks about the federal health care law with a CVS customer.

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."

This story is part of a reporting partnership that includes NPR, KUHF and Kaiser Health News.

Copyright 2013 Houston Public Media News 88.7

Carrie Feibel is a senior editor on NPR's Science Desk, focusing on health care. She runs the NPR side of a joint reporting partnership with Kaiser Health News, which includes 30 journalists based at public radio stations across the country.