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Despite Obstacles, Local Governments Pursue Obamacare Enrollment




Lindsay Berlanga, center, site manager for Cognazante, helps Melissa Villareal, right, and her mother, Hortensia Villareal, rear, with registration for the Affordable Care Act during assistance hours at Bibliotech, the new digital public library in San Antonio, Friday, January 17, 2014.

January 27, 2014 By BECCA AARONSON, texastribune.org

To coordinate education and outreach efforts associated with the Affordable Care Act, the Houston Department of Health and Human Services is taking an approach that mirrors how the Federal Emergency Management Agency might react to a catastrophe.

The Enroll Gulf Coast initiative has set up an “incident command structure” to synchronize the activities of 13 organizations in Harris and 12 nearby counties.  An “intelligence committee” created heat maps showing the ZIP codes with the region’s highest number of uninsured residents and “access” points, like community centers and libraries, to connect with people in those neighborhoods. Meanwhile, an “operations committee” uses that information to host canvassing and health insurance enrollment events in targeted neighborhoods. The groups also share an online dashboard to input data and track their coordinated enrollment efforts in real time.

“The number of uninsured people that we have here in Harris County, 1.1 million, yeah, that’s a public health emergency,” said Ben Hernandez, deputy assistant director for the Houston Department of Health and Human Services. “That’s why it’s easy for us to say, 'Let’s treat it like we’d treat a hurricane.'" 

While no one believed carrying out the Affordable Care Act in Texas would be easy, a series of additional obstacles has impeded efforts to help the 6.2 million uninsured Texans find health coverage. The launch of the federal marketplace, healthcare.gov, was a technical disaster. The state’s Republican leadership, saying Medicaid is broken, has refused to expand the program for impoverished adults. And last week, the Texas Department of Insurance issued state regulations that added further training and other requirements for the navigators hired and trained by recipients of federal grants to help people enroll in the health marketplace.

Still, government officials and community-based organizations are working together to incorporate new rules, maximize their resources and educate uninsured Texans on how to take advantage of the federal law. 


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