Officials in Texas rushed to sign people up for health plans Monday as they faced a looming deadline for those buying coverage under the new federal health care law to have their plans kick in Jan. 1.
In Dallas and Houston, hundreds of people trained to assist with enrollment worked the day before Christmas Eve, forgoing a vacation day that many others enjoyed.
Open enrollment continues through March 31, but for those who want their insurance plans to go into effect on New Year's Day, Monday was supposed to be the last day to enroll in Texas and many other states. But the federal agency overseeing the rollout, expecting a rush of people to enroll at the last minute, extended the deadline through Tuesday, giving them an extra day to choose a plan.
At Parkland Hospital in North Texas Monday, there was an overflow waiting room for health care coverage.
Health care applicant Mazen Altaee was there.
"I tried to find a plan for me but I couldn't find it online," said Altaee. "That's why I came here; to get some help."
Altaee has been unemployed and uninsured for now for about a year.
"Before this law, we used to pay a lot of money to get health insurance, but now, I can pay less money to get health insurance," said Altaee.
Perfecto Garcia, 52, has never had insurance until now.
"I no visit [sic] because I don't have any money for pay visit for medicine," said Garcia.
But for some, whether they came in or tried at home online, health care coverage won't be available to them.
"The first thing I looked at was no-cost insurance," said Joel Lazarus, who's been out of work for three years with pre-existing conditions. He tried to navigate healthcare.gov for no-cost health coverage.
"…and it said that Medicaid was an option, check and see if you're eligible," said Lazarus. "And when I pulled it up, it said that Medicaid is not eligible in the State of Texas."
Gov. Perry says Medicaid is a broken system that needs to be reformed by allowing states more flexibility, saying that "Texas will not be held hostage by the Obama administration's attempt to force us into the fool's errand of adding more than 1 million Texans to a broken system."
"It's heartbreaking," said Dallas County Judge Clay Jenkins. "Our governor has turned down 100 percent funded by the government Medicaid expansion."
What Lazarus did find on the Affordable Care website is that simply, for him, insurance is unaffordable.
"For me to get insurance, it's $211 a month with a $6,000 deductible on my whopping income of less than $500 a month in food stamps."
Lazarus has given up on getting any kind of health care coverage.
About 25 percent of Texas residents, or some 6 million people, lack health insurance. It is the highest rate in the nation. Caring for those people costs millions of taxpayer dollars annually, officials said. So the opportunity to get them health insurance through President Barack Obama's signature law is key to lowering those costs, Jenkins said. About 14,000 Texans enrolled for coverage in October and November.
In Dallas and Houston, health care workers and nonprofit groups doing outreach to the uninsured held dozens of events in recent days.
"We did have a lot of events leading up to this day. We had one on Friday, Saturday, Sunday, Thursday, pretty much at least one, usually two or three events, every day last week," said Mario Castillo, who is leading outreach and enrollment efforts in a 13-county region surrounding Houston for Enroll America, a nonprofit whose mission it is to get people coverage under the new law.
Among the people who turned out Monday were many eager to enroll for coverage that would begin Jan. 1, Castillo said. Many people wrongly believed they also had to pay on Monday for Jan. 1 coverage, so part of the job was explaining that payments were not due at the same time, Castillo said.
Getting Texans to enroll is crucial to the law's success. In Dallas County alone, Jenkins said, taxpayers spent some $685 million in 2012 to care for those who lack insurance, much more than the $430 million the county collected in hospital taxes.
The Associated Press contributed to this story.
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