News / USA

    Obamacare Sign-up Effort Finds Urban Allies in Republican States

    Holding a sign saying "We Love ObamaCare" supporters of health care reform rally in front of the Supreme Court in Washington, Mar. 27, 2012.
    Holding a sign saying "We Love ObamaCare" supporters of health care reform rally in front of the Supreme Court in Washington, Mar. 27, 2012.
    Reuters
    Behind the political battle lines on Obamacare, the three-story headquarters of Change Happens rises like a fortress in a blighted southeast Houston neighborhood of tiny wood-frame shacks, empty lots and crack houses.
     
    The Rev. Leslie Smith has been running the nonprofit that helps poor adults and children with Medicaid enrollment, homeless support and HIV prevention since 1989. Now he is planning how best to reach uninsured people in the communities he serves with the offer of new healthcare benefits under President Barack Obama's landmark reform law.
     
    “Two weeks ago, there was a shootout at the corner that left over 200 shell casings on the ground,” Smith said, speaking in the parking lot as he noted a row of first-floor windows set high and narrow to protect against stray bullets from gunfights between rival gangs. “This is the bottom. This is crack alley. All the ills of the community are around us.”
     
    Even among “red” states, Texas has stood out in its fierce opposition to the Patient Protection and Affordable Care Act, better known as Obamacare. Republican Governor Rick Perry has long been an opponent, and Republican Senator Ted Cruz is leading a charge in Congress to eliminate funding for the healthcare law at the risk of shutting down the federal government.
     
    But in their backyard, one of the best-organized of red-state efforts to reach millions of America's uninsured has taken root.
     
    Healthcare reform advocates like Smith believe the realities of life without health coverage will drive large numbers of young, healthy, low-income people to subsidized insurance premiums and other benefits that Obamacare will begin offering to the public starting on Oct. 1.
     
    His organization is part of a loose confederation of nonprofits, charities, universities, religious groups, government agencies and private companies, known collectively as “navigators,” that is helping Americans sign up for coverage. It is a task Smith zealously embraces.
     
    “Something great is going to happen from this effort,” he says. “I believe this is history.”
     
    Organized in Texas
     
    Obamacare's success or failure depends on how many healthy young adults enroll in health insurance that will be sold on new state exchanges, helping offset the cost of sicker beneficiaries. Administration officials hope they will account for about 40 percent of the 7 million people expected to sign up for private coverage in 2014.
     
    That calculation has put a premium on urban neighborhoods in places like Houston, Los Angeles, Miami and Chicago, four metropolitan areas with a combined uninsured population of 4.8 million - many of them lower-income blacks and Latinos aged 18 to 35, according to U.S. Census figures.
     
    Organizers face special challenges in Texas and Florida, where Republican leaders rejected the opportunity to set up new insurance marketplaces and collect billions of dollars in government funds to expand Medicaid. Perry and other Texas Republicans are now pushing to impose regulations including fees, extra training and surety bond requirements on navigator groups.
     
    Conservatives in the state echo claims made by critics elsewhere, who say the navigator program has been put together too rapidly and requires too little training to safeguard the public. They also contend that Obamacare will raise healthcare costs overall and strap low-income beneficiaries with plans that restrict access to medical services.
     
    Meanwhile, they dismiss the network of volunteers and nonprofits lining up to promote Obamacare as overly optimistic about its value to the public.
     
    “It's a touch naive,” said John Davidson of the conservative Texas Public Policy Foundation. “There's a feeling that the law is half-baked and that the navigator program is half-baked.”
     
    Political opposition has created an atmosphere that makes it difficult even for Democrats to talk openly about the law.
     
    “I don't want to talk about the Affordable Care Act on camera,” Dallas County Administrator Clay Jenkins, a Democrat and healthcare reform supporter, joked as local TV crews set up for a summer press conference with U.S. Health and Human Services Secretary Kathleen Sebelius. “I want to talk about the opportunity to get people covered,” he said.
     
    But it has also helped turn grassroots Obamacare advocates into a well-oiled network. In Texas, the effort was born of an intensive, but ultimately fruitless, months-long attempt to persuade Perry to expand Medicaid last spring.
     
    Change Happens is one of three navigator organizations that have received federal money to hire and train staff to help enroll people in Houston's Harris County, home to nearly 20 percent of the state's 5.8 million uninsured. The group has pledged to reach nearly 100,000 people by the time enrollment wraps up in March. Smith thinks the final number could be close to 300,000 with help from sister organizations across five southeast Texas counties.
     
    Houston's Health and Human Services Department - an agency in a city government whose elected officials are largely Democratic - is also a navigator. It has organized outreach groups under a command structure developed to combat hurricanes. Its public-health database, which is normally used to track epidemics, will measure the enrollment effort's penetration of neighborhoods with large uninsured populations. The city is also providing a consolidated “800” number for public queries, has set aside a “war room” for organizers and is encouraging other major cities to consider the same strategy.
     
    “We really have to bring some science into our approach,” said Stephen Williams, the department's director. “This is an opportunity of a lifetime.”
     
    The Texas Organizing Project (TOP), a grassroots advocacy group with nearly 20,000 low- to moderate-income members, many of them uninsured, has also been running Obamacare canvasses and workshops since May. Earlier this month it packed hundreds of uninsured people into a university auditorium for an Obamacare rally and information session.
     
    “We run the largest issue-driven grassroots get-out-the-vote campaign, and in 2012, we targeted roughly 200,000 voters. Their No. 1 issue, that we identified after talking to them door to door and over the phone, was healthcare,” said TOP Executive Director Ginny Goldman.
     
    Houston's Erenea Perez has heard the message from TOP organizers.
     
    Perez, a single mother in her late 20s who says she is a U.S. resident from El Salvador, works two minimum-wage jobs but can't afford insurance. She counts off the benefits she hopes to obtain with Obamacare subsidies: “Extended maternity services. Pediatric services. Coverage for exams or the ER. Medicine. In-patient services. Ambulatory services.”
     
    Many of her uninsured peers across the country are only now starting to pay attention. Local advertising is expected to begin in earnest across the country on Oct. 1. Earlier this month volunteers in 10 states, including Texas, Florida, Illinois and Michigan, began canvassing campaigns.

    You May Like

    Clinton, Trump and the 'Woman’s Card'

    Ask supporters of Democratic front-runner in US presidential campaign, and they’ll tell you Republican presidential candidate is playing a dangerous hand

    Russian Censorship Group Seeks Chinese Help to Better Control Internet

    At recent Safe Internet League forum in Moscow, speakers from both nations underscored desire for authorities to further limit and control information online

    Video Makeshift Pakistani School Helps Slum Kids

    Free classes in Islamabad park serve a few of the country’s nearly 25 million out-of-school youths; NGO cites ‘education crisis’

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Turkish Kurd Islamist Rally Stokes Tensionsi
    X
    April 29, 2016 12:28 AM
    In a sign of the rising power of Islamists in Turkey, more than 100,000 people recently gathered in Diyarbakir, the main city in Turkey’s predominantly Kurdish southeast, to mark the birthday of the Prophet Muhammad. The gathering highlighted tensions with the pro-secular Kurdish nationalist movement. Dorian Jones reports from Diyarbakir.
    Video

    Video Turkish Kurd Islamist Rally Stokes Tensions

    In a sign of the rising power of Islamists in Turkey, more than 100,000 people recently gathered in Diyarbakir, the main city in Turkey’s predominantly Kurdish southeast, to mark the birthday of the Prophet Muhammad. The gathering highlighted tensions with the pro-secular Kurdish nationalist movement. Dorian Jones reports from Diyarbakir.
    Video

    Video Pakistani School Helps Slum Kids

    Master Mohammad Ayub runs a makeshift school in a public park in Islamabad. Thousands of poor children have benefited from his services over the years, but, as VOA's Ayesha Tanzeem reports, roughly 25 million school-age youths don't get an education in Pakistan.
    Video

    Video Florida’s Weeki Wachee ‘Mermaids’ Make a Splash

    Since 1947, ‘mermaids’ have fascinated tourists at central Florida’s Weeki Wachee Springs State Park with their fluid movements and synchronized ballet. Performing underwater has its challenges, including cold temperatures and a steady current, as VOA’s Lin Yang and Joseph Mok report.
    Video

    Video Somali, African Union Forces Face Resurgent Al-Shabab

    The Islamic State terror group claimed its first attack in Somalia earlier this week, though the claim has not been verified by forces on the ground. Meanwhile, al-Shabab militants have stepped up their attacks as Somalia prepares for elections later this year. Henry Ridgwell reports there are growing frustrations among Somalia’s Western backers over the country’s slow progress in forming its own armed forces to establish security after 25 years of chaos.
    Video

    Video Bangladesh Targeted Killings Spark Wave of Fear

    People in Bangladesh’s capital are expressing deep concern over the brutal attacks that have killed secular blogger, and most recently a gay rights activist and an employee of the U.S. embassy. Xulhaz Mannan, an embassy protocol officer and the editor of the country’s only gay and transgender magazine Roopban; and his friend Mehboob Rabbi Tanoy, a gay rights activist, were hacked to death by five attackers in Mannan’s Dhaka home earlier this month.
    Video

    Video Documentary Tells Tale of Chernobyl Returnees

    Ukraine this week is marking the 30th anniversary of the world's worst nuclear accident, at the Chernobyl nuclear power plant. Soviet officials at first said little about the accident, but later evacuated a 2,600-square-kilometer "exclusion zone." Some people, though, came back. American directors Holly Morris and Anne Bogart created a documentary about this faithful and brave community. VOA's Tetiana Kharchenko reports from New York on "The Babushkas of Chernobyl." Carol Pearson narrates.
    Video

    Video Nigerians Feel Bite of Buhari Economic Policy

    Despite the global drop in the price of oil, Nigerian President Muhammadu Buhari has refused to allow the country's currency to devalue, leading to a shortage of foreign exchange. Chris Stein reports from Lagos businessmen and consumers are feeling the impact as the country deals with a severe fuel shortage.
    Video

    Video  Return to the Wild

    There’s a growing trend in the United States to let old or underused golf courses revert back to nature. But as Erika Celeste reports from one parcel in Grafton, Ohio, converting 39 hectares of land back to green space is a lot more complicated than just not mowing the fairway.
    Video

    Video West Urges Unity in Libya as Migrant Numbers Soar

    The Italian government says a NATO-led mission aimed at stemming the flow of migrants from Libya to Europe could be up and running by July. There are concerns that the number of migrants could soar as the route through Greece and the Balkans remains blocked. Western powers say the political chaos in Libya is being exploited by people smugglers — and they are pressuring rival groups to come together under the new unity government. VOA's Henry Ridgwell reports.
    Video

    Video Russia’s TV Rain Swims Against Tide in Sea of Kremlin Propaganda

    Russia’s media freedoms have been gradually eroded under President Vladimir Putin as his government has increased state ownership, influence, and restrictions on critical reporting. Television, where most Russians get their news, has been the main target and is now almost completely state controlled. But in the Russian capital, TV Rain stands out as an island in a sea of Kremlin propaganda.

    Special Report

    Adrift The Invisible African Diaspora