Groups encouraged by success in Texas in reaching uninsured but say more work remains

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HOUSTON — Community groups, health advocates and insurers remain encouraged by their success in Texas — which has the highest uninsured rate in the nation — in signing up residents for health insurance during the first round of open enrollment under the Affordable Care Act.

But ahead of the second round of open enrollment, which starts Saturday and runs through Feb. 15, these organizations say more work remains in reaching out to some of the state's largest pockets of uninsured, particularly Hispanics, and educating them about buying and using health insurance.

"We've enhanced our resources around education, engagement and enrollment. We're feeling pretty good about the second enrollment," said Dr. Bob Morrow, chief medical officer for Houston and Southeast Texas for Blue Cross and Blue Shield of Texas, the state's largest health insurer, which is partnering with community groups and others around the state to reach out to the uninsured through its "Be Covered Texas" campaign.

For Jennifer Sanchez, getting health insurance for herself and her family during the first round of enrollment meant freedom to pursue goals in her life.

"For me it was a big deal to have health insurance. There's a lot of peace of mind that came with that and security, so much so that I started going to school because I was able to not worry about my health care and how to pay for that," the 23-year-old Houston resident said Friday while getting information at a city-sponsored event about re-enrolling.

Texas declined to set up its own insurance exchange as Gov. Rick Perry staunchly opposed the Affordable Care Act. The state's Legislature also required "navigators," those hired to assist people with signing up, to undergo additional training and background checks.

Despite those roadblocks, 733,757 individuals in Texas selected an insurance plan between October 1, 2013 and March 31, 2014, exceeding enrollment projections of about 629,000.

Texas enrollment remains crucial to the program's overall success because the state has the highest rate of uninsured in the nation, 22.1 percent.

Mimi Garcia, Texas' state director for Enroll America, a nonprofit established to educate people about the Affordable Care Act, said some of the lessons learned from the first enrollment period include ensuring that people who are interested in signing up for insurance get one-on-one help from a navigator or another individual as quickly as possible. New software will allow organizers to immediately schedule appointments with navigators.

Enroll America and other groups will also continue their outreach efforts in the state's Hispanic communities. About 38 percent of Texas' 26 million residents are Hispanic, according to the U.S. Census. Federal data shows that 39 percent of Texas Hispanics are uninsured, compared to 17 percent of whites and 22 percent of blacks. During the first enrollment period, only about 4.5 percent of the state's population of uninsured Hispanics signed up. People who are in the country illegally are not eligible for coverage under the law.

A study in May by the Baker Institute at Rice University in Houston found that toward the end of the first enrollment period Hispanics were more than twice as likely as whites to have enrolled through the insurance exchange.

Dr. Austin King, president of the Texas Medical Association and a head and neck specialist from Abilene, said both doctors and patients dealt with various problems as people began using their insurance. Some of these problems included patients not being educated about what their policies did and did not cover and concerns from physicians about having to pay insurers for services rendered to patients if patients don't pay their premiums.

Between Nov. 1, 2013, and Oct. 31, 2014, the Texas Department of Insurance received 1,303 complaints related to the Affordable Care Act, with 772 specifically related to the insurance exchange. The top complaints concerned delays related to service and excessive rates.

"We are finally working through the confusion part and now we are going to have to wait and see ... if this really brings a substantial amount of people into having insurance who did not have it before," King said.


Follow Juan A. Lozano on Twitter at http://www.twitter.com/juanlozano70.

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