Local officials asked to help on health law

The White House is recruiting mayors, county commissioners and other local officials to promote and carry out President Obama's health care law in states like Florida and Texas, where governors are hostile to it.

The effort comes as the administration is intensifying its campaign to publicize new health insurance options and to persuade consumers, especially healthy young people, to sign up for coverage when open enrollment starts on Oct. 1.

To bring people into the insurance market, the White House is using techniques it used to mobilize voters during Mr. Obama's re-election campaign, with a particular focus on Hispanics, who are much more likely than other Americans to be uninsured. About 7 in 10 Hispanic voters nationally and 6 in 10 in Florida voted for Mr. Obama last year, according to exit polls by Edison Research.

White House officials say the law will provide 10 million uninsured Hispanics with an opportunity to get affordable insurance. They account for 40 percent of the 25 million uninsured Americans expected to gain coverage in the next three years.

Texas and Florida refused to set up regulated marketplaces, known as exchanges, for the sale of subsidized insurance, leaving the task to the federal government. And they have refused to expand Medicaid to provide insurance for low-income people who do not already qualify.

Florida led legal challenges to the law, which was eventually upheld by the Supreme Court. Gov. Rick Perry of Texas, a Republican, said that expanding Medicaid would be like "adding a thousand people to the Titanic." The expansion of Medicaid and the creation of an insurance exchange, he said, "represent brazen intrusions into the sovereignty of our state."

But many local officials said they would help people take advantage of the law.

The chief executive of Dallas County, Tex., Judge Clay Lewis Jenkins, a Democrat, said: "The exchange is a tremendous opportunity to reduce the number of uninsured. It's important that we move aggressively, as soon as possible, to get information to our citizens in a format they can use."

Many people who could benefit from the law are unaware of it, according to surveys by the Kaiser Family Foundation and others. Early this month, Kaiser found that 79 percent of the public and 87 percent of the uninsured had heard little or nothing about the health insurance marketplaces, a centerpiece of the 2010 law.

To reduce those numbers, White House officials met recently with state library officials. Consumers often turn to public libraries for information about government services, and the American Library Association is telling its members to expect a "rush of patrons" who will need help completing insurance application forms.

"We are in the business of providing factual information," said Maureen Sullivan, the president of the association.

In Texas, as in a number of states, counties have legal obligations to help pay for the care of the indigent. County officials see the federal law as a way to help reduce those expenses.

"More than almost anyone else," Mr. Jenkins said, "we will benefit from a reduction in the cost of unreimbursed care, on which we spend $562 million a year. I have reached out to public relations firms, to hospitals, to insurance companies, to the bishop of the Catholic Diocese of Dallas, to a lot of churches and religious institutions, and urged them to join our effort."

Some Republicans will also spread the word.

Mayor Robert Cluck of Arlington, Tex., a Republican, said he did not want to discuss the Affordable Care Act but did want to help people get "proper health care."

"When the new health insurance system begins, it will be very complicated and very confusing," Mr. Cluck said. "A lot of people will need a lot of help. Whatever we can do as community leaders, to help people understand the changes, it's our responsibility to do."

In Houston, State Representative Garnet F. Coleman, a Democrat, said, "We will hold events at zoos, museums and other sites where people can fill out applications and enroll on the spot."

In Florida, two Democratic legislators, Representative Jose Javier Rodriguez of Miami and Senator Eleanor Sobel of Broward County, said they recently participated in a conference call organized by White House officials who sought their help in carrying out the law.

"We clearly do not have an ally in Tallahassee," Mr. Rodriguez said. "So we are working directly with community groups and officials in Washington to make sure people here have access to affordable health insurance plans in the exchange."

The White House said the administration had no choice but to bypass the governor's office in states where Republican executives were balking. "Mayors are very, very involved," a White House official said. "State legislators are very, very involved."

Susan Hepworth, a spokeswoman for the Republican Party of Florida, said: "It's no surprise that the Obama administration is launching a public relations campaign to pump up their base about the implementation of Obamacare. It's so incredibly unpopular that no amount of town halls or forums will stop the bleeding. This is their attempt at triage."

Steve Munisteri, the chairman of the Republican Party of Texas, said: "We are not opposed to county judges or county commissioners providing information to people about their options. But health insurance will still be too expensive for some people, even with federal tax credits, because President Obama has not delivered on his campaign promise to lower the cost of insurance."

Dr. Thomas L. Schlenker, the public health director in San Antonio, said, "We will put some of our employees through 30 hours of training so they can identify people who are eligible for insurance and give them information on how to enroll."

"We may assign some of our staff to sit with folks at computers and help them through the whole process," Dr. Schlenker said. "It will be complicated. It will be confusing. But for the people who get connected to insurance, we are convinced it will do a lot of good."

With open enrollment just months away, the White House and its allies are making a renewed effort to improve public perceptions of the law.

Organizing for Action, a grass-roots group that grew out of Mr. Obama's re-election campaign, is running television advertisements that promote the law. Katie Hogan, a spokeswoman for the group, said it would spend at least $1 million on such ads.

Enroll America, a nonprofit group led by veterans of the Obama White House and the Obama campaign, said it would flood neighborhoods with volunteers, encouraging people to "get covered." And it is trying to enlist sports stars and celebrities as spokespeople.

By Robert Pear

Source: The New York Times