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

    Former US Envoys Urge Obama to Delay Troop Cuts in Afghanistan

    Keeping troop levels up during conflict with both Taliban and Islamic State is necessary to support Kabul government, they say

    First Lady to Visit Africa to Promote Girls' Education

    Michele Obama will be joined by daughters and actresses Meryl Streep and Freida Pinto

    Video NYSE Analyst: Brexit Will Continue to Place Pressure on Markets

    Despite orderly pricing and execution strategy at the New York Stock Exchange, analyst explains added pressure on world financial markets is likely

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Brexit Vote Plunges Global Markets Into Unchartered Territoryi
    X
    June 24, 2016 9:38 PM
    British voters plunged global markets into unknown territory after they voted Thursday to leave the European Union. The results of the Brexit vote, the term coined to describe the referendum, caught many off guard. Analysts say the resulting volatility could last for weeks, perhaps longer. Mil Arcega reports.
    Video

    Video Brexit Vote Plunges Global Markets Into Unchartered Territory

    British voters plunged global markets into unknown territory after they voted Thursday to leave the European Union. The results of the Brexit vote, the term coined to describe the referendum, caught many off guard. Analysts say the resulting volatility could last for weeks, perhaps longer. Mil Arcega reports.
    Video

    Video Orlando Shooting Changes Debate on Gun Control

    It’s been nearly two weeks since the largest mass shooting ever in the United States. Despite public calls for tighter gun control laws, Congress is at an impasse. Democratic lawmakers resorted to a 1960s civil rights tactic to portray their frustration. VOA’s Carolyn Presutti explains how the Orlando, Florida shooting is changing the debate.
    Video

    Video Tunisian Fishing Town Searches for Jobs, Local Development Solutions

    As the European Union tries to come to grips with its migrant crisis, some newcomers are leaving voluntarily. But those returning to their home countries face an uncertain future.  Five years after Tunisia's revolution, the tiny North African country is struggling with unrest, soaring unemployment and plummeting growth. From the southern Tunisian fishing town of Zarzis, Lisa Bryant takes a look for VOA at a search for local solutions.
    Video

    Video 'American Troops' in Russia Despite Tensions

    Historic battle re-enactment is a niche hobby with a fair number of adherents in Russia where past military victories are played-up by the Kremlin as a show of national strength. But, one group of World War II re-enactors in Moscow has the rare distinction of choosing to play western ally troops. VOA's Daniel Schearf explains.
    Video

    Video Experts: Very Few Killed in US Gun Violence Are Victims of Mass Shootings

    The deadly shooting at a Florida nightclub has reignited the debate in the U.S. over gun control. Although Congress doesn't provide government health agencies funds to study gun violence, public health experts say private research has helped them learn some things about the issue. VOA's Carol Pearson reports.
    Video

    Video Trump Unleashes Broadside Against Clinton to Try to Ease GOP Doubts

    Recent public opinion polls show Republican Donald Trump slipping behind Democrat Hillary Clinton in the presidential election matchup for November. Trump trails her both in fundraising and campaign organization, but he's intensifying his attacks on the former secretary of state. VOA National Correspondent Jim Malone reports.
    Video

    Video Muslim American Mayor Calls for Tolerance

    Syrian-born Mohamed Khairullah describes himself as "an American mayor who happens to be Muslim." As the three-term mayor of Prospect Park, New Jersey, he believes his town of 6,000 is an example of how ethnicity and religious beliefs should not determine a community's leadership. Ramon Taylor has this report from Prospect Park.
    Video

    Video Internal Rifts Over Syria Policy Could Be Headache for Next US President

    With the Obama administration showing little outward enthusiasm for adopting a more robust Syria policy, there is a strong likelihood that the internal discontent expressed by State Department employees will roll over to the next administration. VOA State Department correspondent Pam Dockins reports.
    Video

    Video Senegal to Park Colorful ‘Cars Rapide’ Permanently

    Brightly painted cars rapide are a hallmark of Dakar, offering residents a cheap way to get around the capital city since 1976. But the privately owned minibuses are scheduled to be parked for good in late 2018, as Ricci Shryock reports for VOA.
    Video

    Video Florida Gets $1 Million in Emergency Government Funding for Orlando

    The U.S. government has granted $1 million in emergency funding to the state of Florida to cover the costs linked to the June 12 massacre in Orlando. U.S. Attorney General Loretta Lynch announced the grant Tuesday in Orlando, where she met with survivors of the shooting attack that killed 49 people. Zlatica Hoke reports.
    Video

    Video How to Print Impossible Shapes with Metal

    3-D printing with metals is rapidly becoming more advanced. As printers become more affordable, the industry is partnering with universities to refine processes for manufacturing previously impossible things. A new 3-D printing lab aims to bring the new technology closer to everyday use. VOA's George Putic reports.
    Video

    Video Big Somali Community in Minnesota Observes Muslim Religious Feast

    Ramadan is widely observed in the north central US state of Minnesota, which a large Muslim community calls home. VOA Somali service reporter Mohmud Masadde files this report from Minneapolis, the state's biggest city.

    Special Report

    Adrift The Invisible African Diaspora