The Texas Tribune describes how. The effort is based on emergency management:
To coordinate education and outreach efforts associated with the Affordable Care Act, the Houston Department of Health and Human Services is taking an approach that mirrors how the Federal Emergency Management Agency might react to a catastrophe.
The Enroll Gulf Coast initiative has set up an “incident command structure” to synchronize the activities of 13 organizations in Harris and 12 nearby counties. An “intelligence committee” created heat maps showing the ZIP codes with the region’s highest number of uninsured residents and “access” points, like community centers and libraries, to connect with people in those neighborhoods. Meanwhile, an “operations committee” uses that information to host canvassing and health insurance enrollment events in targeted neighborhoods. The groups also share an online dashboard to input data and track their coordinated enrollment efforts in real time.
“The number of uninsured people that we have here in Harris County, 1.1 million, yeah, that’s a public health emergency,” said Ben Hernandez, deputy assistant director for the Houston Department of Health and Human Services. “That’s why it’s easy for us to say, 'Let’s treat it like we’d treat a hurricane.'"
While no one believed carrying out the Affordable Care Act in Texas would be easy, a series of additional obstacles has impeded efforts to help the 6.2 million uninsured Texans find health coverage. The launch of the federal marketplace, healthcare.gov, was a technical disaster. The state’s Republican leadership, saying Medicaid is broken, has refused to expand the program for impoverished adults. And last week, the Texas Department of Insurance issued state regulations that added further training and other requirements for the navigators hired and trained by recipients of federal grants to help people enroll in the health marketplace.
Still, government officials and community-based organizations are working together to incorporate new rules, maximize their resources and educate uninsured Texans on how to take advantage of the federal law.
The national government has bypassed the state government by working directly with counties to educate potential enrollees about the law. Restrictions on "navigators" seems to be the best weapon the state has come up with to restrict enactment of the law in Texas:
The federal Department of Health and Human Services awarded $11 million to organizations in Texas to hire and train navigators. They are required to receive 20 to 30 hours of training under federal law.
The United Way of Tarrant County received the largest grant, $5.8 million, and has distributed the money to 17 organizations around the state. There are 165 navigators in that consortium, including 13 hired by the city of Houston. To expand its efforts, Hernandez said the Houston health department has trained 90 city employees to become navigators and expanded their job responsibilities.
The Houston health department is also working with government entities and community-based organizations in Dallas, El Paso, Austin and the Rio Grande Valley to extend Enroll Gulf Coast’s strategy across the state, Hernandez said.
Tim McKinney, the chief executive of United Way of Tarrant County, said navigators within their consortium had conducted 10,000 one-on-one information sessions with Texans, and enrolled 914 people in health plans, as of Dec. 31.
“The primary mission of a navigator — it’s really not to enroll, it’s to educate and inform,” he said.
Democrats and some health care advocates are critical of the new state rules, saying they are intended to obstruct navigators’ work by adding additional costs and training requirements during the final weeks of the six-month enrollment period.
“It’s really difficult to say that it’s not a politically motivated stunt,” said Tiffany Hogue, statewide campaign coordinator for Texas Organizing Project, political advocacy group for low-income Texans that is working with government entities in Dallas, San Antonio and the Rio Grande Valley to educate Texans on the their insurance options..
The insurance department has said that “unrelated political considerations would be an inappropriate basis for the rules,” and that its intent is to broaden the pool of qualified navigators
