WESLACO, September 24 - A “navigator” group helping Rio Grande Valley residents enroll through the new health insurance marketplace says it is staying focused on its work despite U.S. Sen. Ted Cruz’s efforts to defund the Affordable Care Act.
MHP was awarded $589,750 by the Centers for Medicare and Medicaid Serves to inform the public in the four-county Valley area about the health insurance market place and to help people understand and navigate their insurance options. The group wants 4,200 Valley residents to receive “navigator” services.
MHP, based in Weslaco, has hired seven full-time promotoras to do outreach in the community. The seven begin work on Wednesday and will soon be fanning out to different community groups to start the education process. From Oct. 1, Valley residents can sign up for health insurance through the new marketplace. On that date, MHP will hold a public meeting about the marketplace concept at McAllen Public Library. More public meetings, as well as billboards and TV and radio advertising are planned.
Asked if Sen. Cruz’s efforts to defund ACA were having an impact, Rachel Udow, a grant writer for MHP, said: “These things have the potential to put us off our game but they have not done so. We are not trying to ignore the context. We are keeping it on our radar. However, we are really focused on getting this work done. Nothing is throwing us off our game.”
Udow said it would be easy for MHP workers to say, “Why are we doing this if it (ACA) is all going to disappear?” However, she said that until it happens she and her colleagues have a job to do. “We are going to do our job. It is really easy to get caught up in it all and wring your hands and stress out. It is not that we do not understand the gravity of the potential implications or because we have blinders on, it is just… what else are we going to do? We want to get people insured. That is the main goal. If you think about it, for each person who is insured how immense an impact that is on their lives and their families. We have to do it.”
Sen. Cruz has said he wants to defund ACA, or “Obamacare” as he calls it, because he does not want government intrusion in the healthcare industry. He believes the private sector can do a better job of ensuring access to healthcare. Texas’ junior senator and others succeeded in persuading the House Republican leadership to pass a continuing resolution that funds the rest of the federal government but defunds ACA. The Democratic majority looks set to block the maneuver in the Senate.
MHP, which was previously known as Migrant Health Promotion, was started 30 years ago in Michigan. It opened its operations in Texas and the Valley in the late 1980s. Its mission statement reads: “Using the promotora model, MHP provides culturally appropriate health education and outreach and sustainable community development to farmworker, migrant, border and/or other underserved or isolated communities throughout the nation through increased knowledge and skill building, individuals and families will be empowered to live healthy rise.”
In addition to Sen. Cruz’s well-publicized efforts to defund ACA, MHP and other navigator groups are also dealing with Gov. Rick Perry’s late intervention on the issue. In a Sept. 17 letter to Texas Department of Insurance Commissioner Julia Rathgeber, Perry called for more training for navigators on the collection and security of data they collect from patients. He said he also wants TDI to be sent any personal information obtained from patients by navigators.
Perry cited Senate Bill 1795, which was passed into law this year and allows TDI to create and enforce more regulations on navigator work. The author of the bill, state Sen. Kirk Watson, believes Perry is hijacking his legislation. The Austin Democrat told KUT Radio that he does not want TDI to impose “onerous, burdensome or ridiculous restrictions” on navigators.
MHP’s Udow said her group is closely monitoring any new regulations from TDI. TDI has scheduled a meeting about new regulations for next Monday.
“We are trying to stay focused on what we were funded to provide, especially because the open enrollment window is so tight. We have from Oct. 1 to March 31 to get people hooked up with coverage. We are staying abreast of what TDI may do, to stay informed, to provide input as appropriate but not get distracted from what we are supposed to do,” Udow said.
Udow said MHP is concerned about privacy and security. “We want to uphold the highest standards. We are confident the standards set by CMS are appropriate and sufficient,” she said. “Our concern is that new regulations from TDI will mean more time and energy on something that seems already efficient to us.”
Udow said MHP has a great working relationship with the three local health centers that have been awarded federal grants to do certified application counselor assistance under ACA. They are Nuestra Clinica del Valle in San Juan, Su Clinica in Harlingen and Brownsville Community Health Center. She said these clinics, along with Enroll America, have formed an ad hoc working group with MHP to ensure Valley residents get the best possible information about the new health insurance marketplace. “If people call 800-461-8394, extension 1011, they will be able to access what MHP is doing and what the other groups are doing throughout the four county Valley region.”
Udow said TOPs, RGV Equal Voice Network, Valley Interfaith and Congressman Rubén Hinojosa’s district office in Edinburg are also doing great work in the community to educate residents on ACA.
“I went to a recent Valley Interfaith event on the Affordable Care Act in Edinburg and I was really impressed. It was very well attended. Groups like Valley Interfaith are well positioned to address the Medicaid Expansion issue, whereas our focus is on the marketplace. We recognize the Black Hole situation and we are glad that there are groups like Valley Interfaith and Equal Voice that are working on that issue. The community collaboration has been pretty smooth. Because these working relationships are going smoothly, I think we will be able to coordinate pretty quickly and respond to things as they come up.”
The “Black Hole” Udow refers to is the name given to a coverage gap that exists in Texas because Gov. Perry and the Legislature refused to expand Medicaid. Middle income Texans will get tax credits to help pay for health insurance in 2014. Families who earn less than $3,697 a year for a family of three can qualify for Medicaid. But, low-income working Texans have fallen into the “Black Hole” and remain uninsured.
“What we know is that people in that group will not have to pay a fee. The question now is how do we ensure these people are not penalized? They have fallen into a category that is exempt. Will they need a hardship waiver? Will they access that through the marketplace? Does it show up at tax time? These are the questions we have right now and CMS is working on getting an answer on that,” Udow said.
Udow concluded her interview with the Guardian by saying MHP’s website is being updated and will have all the relevant information about the health insurance marketplace in the coming weeks. “Anyone who needs more information can call the online chat at healthcare.gov. They can also call the Affordable Care Act Call Center in Brownsville at 800-318-2596. And, they can get in-person assistance at the health centers.”