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Foes of Obamacare fight policy by discouraging enrollment

David Martin Davies
Texas Public Radio

The new Health Insurance Exchanges - where people without health insurance can pick a plan - go live online on Oct. 1. 

In Texas, state leaders are doing all they can to hobble the Affordable Care Act.

Audio transcript

At an ObamaCare community information meeting recently held in San Antonio, Sevi Laura addresses the room crowded with people looking for information about the roll out of the affordable care act.

“It’s great to see a great crowd turn out for this very important issue – my name is Sevi Laura and I’m a proud member of the Texas Organizing Project…”

“Today we’re here to give information about the exchanges that will be happening in October – to make sure everyone has the correct information and knows all the avenues to be able to receive health care.”

Then people took turns telling their personal stories about life without health insurance - stories of high premiums - denials of coverage due to preexisting conditions and the frustration that Texas refused to expand Medicaid which would have helped many of the poorest in the room – Enrique Maydon says he needs Medicaid to be expanded.

Maydon explains that he has diabetes, arthritis and was hurt on the job. Now can’t work. And has no health care. It was Texas Governor Rick Perry who decided not to expand Medicaid. Perry is one of the nation’s loudest opponents of the Affordable Care Act. He made that clear while being interviewed on Fox News.

“We’re not going to expand Medicaid we’re just not going to be a part of – again – socializing health care in the state of Texas and going in direct conflict with our founding fathers’ wishes and freedom for that matter.”

Recently Perry took another step to hinder the Affordable Care Act. He directed the Texas Department of Insurance to establish strict rules to regulate the so-called navigators – these are people hired across the country trained to help folks enroll in Obamacare. Many are focused on going into Spanish speaking neighborhoods and helping minorities.

The Governor’s Office’s Josh Havens says most of the requirements have to do with competency.

Havens: “Including requiring navigators to complete navigators to complete a number of hours of state training in addition to the federal training.  We ask that they pass an exam based on that training.  Refrain from influencing a customer’s decision or a consumer’s decision on which insurance to choose”  :18 secs

Texas isn’t the only state regulating Navigators - 14 other states are also doing so. But Texas announced its intentions just days before the start of enrollment and these new Texas regulations won’t be in place until January 1st. That will keep the navigators from doing their jobs for 3 critical months of the enrollment window.

Jose Ibarra of Enroll America says not having those Navigators is going to make his job tougher in Texas.

“So the Navigators play an integral role in this whole process – they are there to help folk enrolling in insurance step by step.”

If fewer people sign-up in Texas that could strike at the heart of what is supposed to make the Affordable Care Act economically viable.

John Davidson is a health care policy analyst at the conservative Texas Public Policy Foundation.

“The entire scheme of these exchanges in Obamacare depends upon as many people as possible signing up for coverage to dilute the risk pool and the theory is the more people who sign up the more it will drive prices down.”

And Davidson said the opposite also works – if not enough people sign up – then Obamacare could go into a death spiral.

“This happens in insurance markets when not enough healthy people sign up  and there’s too many sick people in the insurance pool with too high of an insurance claims – premiums go up – more healthy people drop out – premiums continue to go up until the market collapses.”

State Representative Mike Villarreal a democrat from San Antonio claims that’s exactly what the state’s republican leadership wants.  

“What they are attempting to do is to discourage – make it harder – make people jump through more hoops – who are particularly younger to sign up and participate in the health care market places and that’s not helpful for anyone.”

One out of 4 Texans do not have health insurance – that’s the largest percentage of uninsured in the nation. If the opponents to Obamacare have a strategy to discourage enrollment in the Exchanges in order to raise the odds collapse - then Texas would be the best place to make that happen.

David Martin Davies reporting.