With its flaws (including complications for residents without bank accounts, as the Current reported), major hallmarks of the Act include banishing a requirement that led to health insurance abuse– Texans with pre-existing conditions can’t be turned away or charged more for coverage under the ACA. An estimated 10.7 million Texas residents with pre-existing conditions could now see health care as a result, according to national non-profit, Families USA.
But in their oftentimes seemingly blind opposition to the Obama administration, the state’s conservative leaders have lined the path to comprehensive health care coverage with barriers galore and the marketplace is no exception.
Texas Sen. Leticia Van de Putte criticized state leaders for making federal health care access difficult. Photo by Mary Tuma
Led by the intensely anti-Obama Gov. Rick Perry, the state’s aversion to the federal administration has made gaining access to expanded health care “extremely difficult” said San Antonio state Sen. Leticia Van de Putte, who along with other political and community leaders, strove to make sure Texans were aware they can still take advantage of the exchange despite the state’s overall hostility to the ACA, during a event at the University Health System Robert B. Green campus last week.
First, there’s Perry’s refusal to expand Medicaid, in effect denying more than 2 million eligible working adults access to health care. The results are predicted to be dire– according to a September 2012 study published in the New England Journal of Medicine, nationwide Medicaid expansions are associated with a “significant reduction” in mortality and would have the effect of decreasing the death rate by 6.1 percent for those over 65 years of age. Kevin Moriarty, president of Methodist Healthcare Ministries of South Texas, Inc., says those numbers translate to 5-6,000 Texans. In other words, by some measures, Perry’s refusal to expand Medicaid could lead to the death of the thousands of Texans.
The “cruelty imposed on working families by the governor and legislators who oppose [the ACA] is just beyond understanding,” said Juan Flores, executive director of the San Antonio-based La Fe Policy Research and Education Center. Their objections create a “blackhole” for the 1.7 million Latinos who could have had the opportunity to benefit from Medicaid. “How much more pain and poor health do we ask working families to endure?” he asked.
State Rep. Elliott Naishtat (D-Austin) called Perry’s move to reject federal Medicaid dollars “short-sighted, mean-spirited and fiscally irresponsible,” during the ACA conference downtown, pointing to the loss of $100 billion over the next ten years in Medicaid funds. Naishtat co-authored a bill during the last Texas Legislative session that would increase eligibility under the ACA– it failed to receive a committee hearing.
And while some states like California, New York and Colorado, decided to set up their own versions of the federal exchanges, Texas isn’t opting to lend an extra hand, leaving the work up to the feds, according to data from the Kaiser Family Foundation. With the exception of a handful of GOP-led states, it looks like the breakdown of which states helped out and which ones didn’t falls pretty squarely along party lines.
Throwing yet another wrench in the works, Perry’s most recent measure to slow down the process falls on health care ‘navigators’–trained individuals who help residents sign up for coverage. Perry has tacked on more stringent regulations for the navigators, like another 40 hours of training (in addition to the 20-30 they’re mandated to undergo), training tests, as well as initial and periodic background checks. Navigators in the Lower Rio Grande Valley Development Council have apparently pulled out of the assistance program due to “intimidation” and “scare tactics” by the state, said Naishtat.
As Van de Putte noted, Medicare navigators already in place aren’t subject to the same rules, “I don’t understand the governor’s insistence– just because it’s the Affordable Care Act, we’re going to make it more difficult for people to get information?”
Other Democratic legislators, including San Antonio Reps. Mike Villarreal and Ruth Jones McClendon have sounded off on Perry’s tightening of navigator rules, arguing the feds currently require significant training and strict privacy protections.
“The Governor has always pushed for less regulation. Now [
] he is pushing for more state regulations on Texans helping their neighbors find health insurance,” wrote Villareal in a statement. "This attempt to discourage Texans from serving as navigators is just his latest move to undermine efforts to provide affordable health insurance options. His actions thwart the democratic process.”
As Texas leads the nation in the greatest percentage of uninsured residents with 25 percent of the population living without health insurance, according to the Texas Medical Association, the ongoing conservative effort to derail expanded health care, as some legislators put it, is all the more troubling. It’s no wonder lawmakers and health leaders in San Antonio (and around the state) felt the need to hold conferences like the one at UHS to dispel worry the marketplace won’t affect them.
Valeria Rodriguez of the Texas Organizing Project, a group that works to help low-income residents through civic engagement, talked about her mother’s struggle with obtaining health insurance due to her pre-existing condition, a barrier now made obsolete under the ACA. While she voiced gratitude for the marketplace’s debut, she noted the hypocrisy in the road to secure affordable access.
“I think the most frustrating thing is, that between Gov. Rick Perry and Attorney General Greg Abbott for 46 years combined they’ve had government-paid health insurance. However it’s almost like they don’t want families like mine to have the same access,” said Rodriguez.
For questions, interested Texans can call 800-318-2596 or live chat at healthcare.gov (cuidadodesalud.gov for Spanish speakers). San Antonio residents can also call (210) 233-7157 for information and enrollment assistance from CommuniCare Insurance Enrollment Department.