S. Texas provides gauge on health care law impact

SAN JUAN, Texas (AP) Promoters of the new federal health care law have spent months crisscrossing border communities in South Texas, speaking to church congregations and making presentations in community centers where some of the nation's largest pockets of uninsured can be found.

They're tasked with spreading the word about an initiative that state leaders have strongly denounced and refused to promote. On Tuesday, so-called navigators and other trained personnel across Texas will begin seeing how many of the state's 6 million uninsured will seek coverage through the health insurance marketplace during the next six months.

The response in Texas' Rio Grande Valley which has some of the nation's most impoverished communities and more than 300,000 people eligible for coverage through the new law will be a closely watched gauge of how well the Affordable Care Act aids its intended targets.

"We will become the poster child for why a comprehensive health plan is a great idea, because you look here and say, 'Oh my god, it's diabetes, it's preventable and it's treatable, but you have to do both consistently and cannot do that without a medical home or a health plan," said Michael Seifert, of the RGV Equal Voice Network, a coalition of 11 community organizations in the Rio Grande Valley.

Hidalgo County, located along the Mexican border, has the highest rate of uninsured among urban counties in the country with about one in three people lacking health coverage. Here diabetes and other obesity-related diseases run rampant and often unchecked until reaching the critical stage.

But the health care overhaul is expected to have a major impact across the state, which leads the nation with about a quarter of its population lacking coverage. Millions of Texans will qualify to shop among the subsidized health plans in the marketplace, but some of those will fall into the gap created by Texas' refusal to expand Medicaid and not be eligible for subsidies on the private plans. Those who don't qualify may be able to get one of a number of exemptions from a federal fine affecting those who aren't covered next year.

The Valley's well-established network of community health workers will be a key element in guiding people through the process. Many have already undergone training to work as health care navigators or certified application counselors the program's front-line guides for the new system and know where to find those most likely to benefit. In the coming months they will carry information into those neighborhoods, explain the system to those already seeking care in community health centers and try to have a presence at a range of community gatherings.

Whether the navigators have the resources to handle the workload during the six-month enrollment period remains to be seen. The groups anticipate the flow of people seeking assistance will be spread out over the coming months. And some hospital staff, insurance agents and others will also be prepared to assist.

"If every single uninsured person in the Valley sought in-person assistance from a navigator or certified application counselor, no, we wouldn't have sufficient capacity," said Rachel Udow, interim program director at Migrant Health Promotion, which received a federal grant to train navigators. "But I think we expect that ... some people may just choose online chat to get their questions answered, some people may log into the marketplace and not seek any assistance, others may try the call center. So it really depends."

Migrant Health Promotion is training seven navigators and preparing a broader outreach campaign in the four-county Valley. Centers for Medicare and Medicaid Services could not provide a statewide total for the number of navigators and counselors who would be trained in Texas, but estimated the number of those providing in-person assistance would be in the thousands with more added as the enrollment period progresses.

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S. Texas provides gauge on health care law impact

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