The top two U.S. health officials are planning multiple trips in the coming months to states led by Republicans hostile to the Affordable Care Act, seeking success there for President Barack Obama’s health-care overhaul despite opposition.
With 63 days left before the law’s insurance exchanges open for customers on Oct. 1, the Obama administration and allies such as the nonprofit group Enroll America are accelerating efforts to sign up at least 2.6 million healthy Americans, even as foes mount a daily drumbeat to scrap it and polls show more Americans oppose the law than support it.
In the last three weeks, Kathleen Sebelius, the U.S. health secretary, and Marilyn Tavenner, the administrator for Medicare and Medicaid, visited Dallas, where Texas Governor Rick Perry, a Republican, has refused to build an insurance exchange or expand the state’s Medicaid program. Tavenner will visit Tennessee next week and Sebelius will be in Georgia the week after that, two states whose governors have taken similar stands.
“We’re going straight to the communities where the need is the greatest, to work with our partners on the ground, to reach people right where they are,” Joanne Peters, a spokeswoman for the Health and Human Services Department, said in an e-mail.
No U.S. state has a higher proportion of uninsured residents than Texas, and the problem weighs on the economies of cities such as Dallas, said Clay Jenkins, a county judge who met with Sebelius during her visit there. About 25 percent of the county’s 2.5 million people lack insurance, he said.
‘Tackling the Problem’
“There’s nothing more important to Dallas County, to our quality of life, and to our economy, than that we tackle the problem of being the fourth-most uninsured county in the country,” Jenkins, the county’s top local elected official, said in a telephone interview.
The law, passed in 2010, creates new online insurance exchanges that will offer as many as 25 million people a chance to buy subsidized health insurance or enroll in Medicaid, the state-federal medical plan for the poor. In areas where state officials have refused to create exchanges, such as Texas, Tennessee and Georgia, the U.S. government will operate the online marketplaces. Enrollment for 2014 will continue until March 31.
Jenkins headed up a group including local business leaders, hospitals, churches and politicians that met with Sebelius on July 23. He wants hospitals, schools and church leaders to promote the law to local residents, and he’s working with two nonprofit advocacy groups, the Texas Organizing Project and Enroll America to knock on doors and host neighborhood events. Jenkins isn’t getting any help from the Texas governor’s office.
Perry has said Texas won’t expand Medicaid unless it is overhauled to reduce costs. He also declined to create an insurance marketplace for people to buy subsidized coverage, leaving the federal government with no choice but to set up the exchange on its own.
“Texas has never measured success by the number of individuals on public assistance,” Lucy Nashed, a spokeswoman for Perry, said in an e-mail. “Obamacare is a deeply flawed, unsustainable and misguided government takeover of our health-care system that will bankrupt the states and our federal government.”
Jenkins, a Democrat, doesn’t see it that way.
“What we’re trying to do right now is not re-litigate or politicize the health-care exchanges, but rather get the information out,” he said. “We welcome any help the state would provide.”
Federally funded health clinics, which treat about 15 million Americans a year, many without insurance, are key to the Obama administration’s enrollment campaign. The government is giving $150 million to the clinics to hire staff who will help patients enroll in health plans.
In Fort Worth, Sebelius addressed the National Association of Counties, which Jenkins said he hopes will circulate “best practices” for informing citizens about the law and enrolling them once exchanges open.
“Our focus now is on making sure families know about the opportunity that is coming when the marketplace opens on Oct. 1,” HHS’s Peters said. “We know it can’t be done by government alone, and it can’t be done only in Washington.