Few Texans Have Found Health Coverage Through Affordable Care Act

Fewer than 3,000 Texans successfully found private health insurance during the first month of the Affordable Care Act’s open enrollment period to purchase a health plan through an online federal marketplace, according to figures released Wednesday by the U.S. Department of Health and Human Services.

President Obama’s signature health reform law requires most Texans to carry health insurance by March 31, 2014. Texas' Republican majority, which vehemently opposes the federal health law, declined to establish a state-based insurance marketplace, so the federal government has done so instead. Although 36 states are participating in the federal marketplace, fewer than 27,000 individuals, including 2,991 Texans, have purchased health plans through the federal website, which has been plagued with technical problems. In comparison, more than 73,000 people have purchased health plans through state-run insurance marketplaces. 

Texas has the nation's highest rate of people without health insurance at 24.6 percent, according to U.S. census data. About 48 million Americans — including more than 6 million Texans — were uninsured in 2011 and 2012.

Texans make up 11 percent of the individuals who have successfully purchased a health plan through the federal marketplace. Overall, more than 1.5 million individuals, including 108,400 Texans, have applied for coverage through the federal or state-run marketplaces, and more than 396,000, including 11,682 Texans, have been determined eligible for Medicaid or the Children’s Health Insurance Program.

Texas is second only to Florida in the number of completed applications, the number of individuals who have applied for coverage and the number of people who have selected a health plan on the marketplace, according to the enrollment figures.

Proponents of the president’s health law, including U.S. Health and Human Services Secretary Kathleen Sebelius, have emphasized that early enrollment is expected to be low. They point out that only 123 people signed up for health coverage in the first month of Massachusetts' roll-out of a similar health insurance mandate, and that enrollment escalated dramatically in the days before a state tax penalty took effect.

“We expect enrollment will grow substantially throughout the next five months, mirroring the pattern that Massachusetts experienced,” Sebelius said in a statement. “They’re also numbers that will grow as the website, healthcare.gov, continues to make steady improvements.”

Sebelius has been under fire since Oct. 1, when the launch of the federal marketplace proved disastrous. Although the federal government has brought in new leadership and staff to fix the website, some officials believe it's unlikely they'll meet their goal to have everything fully functional by the end of November. 

Ken Janda, president and CEO of Community Health Choice, a Houston-based health plan participating in the marketplace, said the organization has only successfully received six applications through the federal marketplace. Although there has been increased traffic on CHC's website and phone lines as many people seek out additional information about the federal insurance requirements, he believes the technical problems with the federal marketplace are obstructing enrollment efforts.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.