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The obstacles to enrollment

The Affordable Care Act could have a big effect in Houston if the people who would benefit by it can be informed about it and assisted as needed.

It's constitutional - deal with it

It’s constitutional – deal with it

Houston, with an estimated 800,000 uninsured residents, ranks among the nation’s largest cities with the highest number of working poor residents – many of whom could be eligible for health coverage under the Affordable Care Act.

Federal officials, lawmakers and community organizers say Houston is fertile ground to sign up the poor and uninsured as insurance marketplaces open Oct. 1 for enrollments.

Yet it’s unclear how the three nonprofit agencies charged with identifying, educating and enrolling uninsured Houstonians will reach so many people. The agencies, which recently were awarded a total of about $7 million in federal grants, will hire and train navigators and subcontractors to guide the state’s 4.8 million uninsured residents through enrollment.

“It’s important to have the community engaged,” said Marjorie Petty, a regional director of the U.S. Health and Human Services Department whose area includes Texas. She spoke this week at a community meeting held by U.S. Rep. Gene Green, D-Houston,

The groups awarded federal funds are Houston’s Change Happens, the United Way of Tarrant County in Fort Worth and the New York City-based National Urban League. They are to assist uninsured residents in signing up for insurance coverage, which takes effect Jan. 1.

However, health economist Vivian Ho said she doesn’t believe organizations that received grants will have enough money to provide the assistance that uninsured residents need to understand what’s available to them under the health law. Ho is the James A. Baker III Institute health economics chair and an economics department professor at Rice University.

“It’s not even close,” Ho said of the grant awards.

“It’s going to take several hours to guide each person through the process,” she speculated. “It’s very disappointing.”

There are numerous organizations working hard to publicize the exchanges. One public information session at UH over the weekend drew several hundred people. There is some federal money to help with these efforts and for advertising. Against that you have the denialism and obstruction of the state government and Republican Congress. I think in the end a lot of people will get signed up, but not nearly as many as could have been. And every illness, every death, and every bankruptcy that happens to a could-have-been-but-wasn’t-covered person will be on those that worked against them getting coverage.

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