Affordable Care Act

At lunchtime on the North Harris campus of Houston's Lone Star Community College, students stream through the lobby of the student services center, plugged into their headphones or rushing to class.

Many walk right past a small information table about the Affordable Care Act.

Texas still has the highest rate of uninsured people in the country, about one in four, and a new survey, the Health Reform Monitoring Survey-Texas report, suggests even some people with health insurance are struggling to pay for it.  

The report looked at how Texans were feeling in September about health care and insurance just before the Affordable Care Act health insurance marketplace launched. Vivian Ho, an economist with Rice University’s Baker Institute for Public Policy, helped produce the report. She says they're trying to measure the impact of the health care law in Texas.

Veronica Zaragovia, KUT News

This story is a result of a partnership with the Austin-American Statesman’s Tim Eaton and Kelly West. You can find more at

By the end of March,  all people in the U.S. legally must have health insurance – or pay a tax penalty next year. That includes refugees, who often lack the English skills to understand the ins and outs of the insurance system.

Todd Wiseman, Texas Tribune

Governor Perry’s decision not to accept federal expansion of Medicaid in Texas means 687,000 women will be left in a "coverage gap," according to a report by the National Women’s Law Center. Those women are too poor to qualify for Medicaid, but don’t make enough money to be eligible for subsidies on the federal health insurance exchange. 

Medicaid eligibility standards in Texas are among the strictest in the nation. A parent in a family of three must make less than $3,737 annually to qualify (19 percent of the federal poverty level), according to the Kaiser Family Foundation. Adults without dependent children are not eligible for Medicaid in Texas. 

Veronica Zaragovia, KUT

Texas now has extra requirements for Affordable Care Act navigators who help consumers find their way around the federally-run health insurance marketplace. 

Beginning at the end of 2013 and lasting through early January, the Texas Department of Insurance listened to public testimony and received more than 300 pages of written comments on the proposed rules.

Veronica Zaragovia, KUT

Almost 120,000 Texans signed up for health insurance through the federally run marketplace through the end of last month, but it’s only a small fraction of the state’s total uninsured population.

And enrollment of Latinos, a group targeted by the Obama administration has had its challenges.

Under Obamacare, nearly every American has to have health insurance or pay a penalty. One of the few exceptions is for people who are members of what’s called “health care sharing ministries.” The two largest sharing ministries – Samaritan and Medi-Share – have both nearly doubled their membership in Texas since the Affordable Care Act.

Veronica Zaragovia, KUT News

Lawmakers and members of the public testified on new Texas-only rules for the Affordable Care Act on Dec. 20 in Austin.

The new rules would restrict who can become a health insurance "navigator" under the Affordable Care Act. These proposed rules have caused controversy: critics say they're meant to impede the success of the federal health care law, whereas supporters say they will teach navigators how to safeguard consumers' information.

The Texas Department of Insurance wrote the proposed rules to regulate navigators. They're already required to go through a federal training before they help people sign up for insurance through the new federal healthcare exchange.

Veronica Zaragovia, KUT

Editor's note: This story has been corrected to reflect the proposed rules from the Texas Department of Insurance.

You may have heard the term navigators lately – they’re the volunteers who can help people sign up for health insurance under the Affordable Care Act.

They go through an online federal training to learn how to help people navigate the federally-run marketplace, though they can't tell anyone which plan to buy. Earlier this year, a number of agencies in Texas received almost $11 million collectively to pay for their training.

Now the Texas Department of Insurance has written proposed state rules that would add 40 hours of training and require a background check for navigators.

The Obama administration announced on Tuesday that former Microsoft executive Kurt DelBene will take over the operation of the troubled website.

DelBene will take over for Jeff Zients, who was appointed by President Obama to rescue the site after it launched with crippling problems. Zients, who Obama had turned to in the past to fix sticky issues, had made it clear that he was not going to stay on the job past December.

Early technical issues with the new healthcare marketplace,, brought serious criticism to an already controversial government initiative. But a new report published by the U.S. Department of Health & Human Services suggests that the tides may be turning for Obamacare.

By the end of November, coverage plan enrollment numbers for Texans had jumped to 14,000 – that’s up from 3,000 the month before.

And many more Texans are on their way to enrolling. According to the same report, nearly a quarter of a million Texans have applied for coverage and are waiting to choose a Marketplace plan. Those numbers are actually the second highest in the nation for states that are supported or fully run by a federal (rather than a state-implemented) healthcare Marketplace.

Oregon might be seen as a complete failure or a surprising success when it comes to its health insurance exchange.

One the one hand, the state's website has yet to allow a single person to enroll. That's a big problem for the folks who are hoping to qualify for subsidies and buy insurance that will start Jan. 1.

Filipa Rodrigues

President Barack Obama’s decision to allow insurance companies to continue offering policies that would be canceled under the Affordable Care Act has an unclear effect on Texans.

In an announcement today, the President said he is leaving it up to states and state insurance commissioners to decide if consumers can keep these plans through 2014.

In a written statement, Texas Governor Rick Perry said the decision makes a bad situation worse, by creating more confusion for consumers. John Davidson with the Texas Public Policy Foundation agrees.

President Obama announced Thursday that Americans who have had their health insurance plans canceled because of his Affordable Care Act can keep those plans for another year if they wish.

Those cancellations — most effective on Jan. 1 — have sparked intense criticism of the ACA, in part because the president pledged many times that if Americans liked the health plans they had, they wouldn't have to give them up under the terms of his program.

Fewer than 3,000 people in Texas signed up for health plans in the first month of enrollment through the Affordable Care Act website, according to data released today [PDF] by the Health and Human Services department.

Other Texas findings in the data:

  • 11,682 Texans were determined to be eligible for CHIP and/or Medicaid through the federal health care marketplace,
  • Almost 54,000 Texans actually completed applications. Those applications would cover more than 108,000 individuals.
  • Most of those applicants – over 80,000 – are eligible to enroll in a health insurance plan available through the federal marketplace– but they haven’t done so yet.  

The woman whose smiling face adorned the website in the first days after its launch has stepped forward to tearfully address those who she says cyberbullied her as they took potshots at the Obama administration's troubled online health exchange.

Veronica Zaragovia, KUT

A push to get people to buy health insurance through the federal marketplace has included plenty of visits from federal officials.

Last week, President Barack Obama told an audience of volunteers in Dallas that affordable health insurance is a pretty big deal in this state.

"There’s no state that actually needs this more than Texas," President Obama says. 

Bob Daemmrich,

Texas Attorney General Greg Abbott has renewed his call for additional training and privacy requirements for “navigators” that help Texas consumers sign up for health insurance through the federally-run Affordable Care Act marketplace.

This week, Abbott wrote a letter to Texas Insurance Commissioner Julia Rathgeber asking her department to draft new privacy standards. In August, Abbott and 12 other attorneys general sent a letter citing privacy concerns to Secretary Kathleen Sebelius of the U.S. Health and Human Services Department.

University of North Texas student Angela Quijano didn’t think about health insurance much before the Affordable Care Act. She says she didn’t know how the health insurance system worked and found getting coverage confusing.

Quijano did know one thing, though: she couldn’t go to the doctor because she didn’t have any health insurance.

“Nobody ever really talks about it. My parents basically told me when I had it, or (when) I didn’t have it,” Quijano, a 22-year-old senior majoring in political science, says. “Not too many of us think about it until it comes time to get a yearly checkup or something comes up.”

One of the big promises of the Affordable Care Act was that encouraging insurance companies to compete to sell their health plans would drive down prices.

Here in Austin, people who choose to buy health insurance on the federally-run health insurance marketplace have dozens of plans to choose from. Texans in many rural parts of the state will find far fewer. But they're not necessarily more expensive than in urban parts.

Take Loving County. It's pretty rural. According to the Census Bureau, just 71 people were living in this West Texas county in 2012, down from 82 in 2010.