ROBERT SIEGEL, HOST:
We're going to two states now to get two very different views of the health care rollout. Oregon has embraced the health law. Though computer troubles have all but shutdown its own online exchange, the state has managed to enroll thousands of people into Medicaid.
AUDIE CORNISH, HOST:
But we're going to start in Texas where only about 3,000 people have signed up for insurance through the federal online exchange. Governor Rick Perry opposes the health law, and Texas is one of at least 16 states that is restricting navigators. They're the workers who help people sign up for health coverage. And that's one more reason advocates say in Texas, the ACA rollout has been especially rocky.
Carrie Feibel of member station KUHF in Houston reports.
CARRIE FEIBEL, BYLINE: Alysia Greer is a health care navigator. She has set up her folding table in the lobby of a medical building in northwest Houston. All she has with her are brochures, her smile and her voice.
ALYSIA GREER: Does everyone in your household have health insurance?
FEIBEL: Most patients walk right by but Dorothy Green stops. She already has Medicaid, but she grabs a packet for a friend.
DOROTHY GREEN: Yeah, my neighbor because she doesn't drive and she's asking me about it and I have no idea, you know, as well as the other folks, you know.
FEIBEL: Texas has already passed a law to restrict navigators but it won't go into effect until the insurance department writes the specific rules. Attorney General Greg Abbott says he wants more regulations that goes beyond those already in the Affordable Care Act. He fears navigators could misuse confidential information they gather while helping people enroll.
GREG ABBOTT: We do need to have criminal background checks. We need to have better training for these people who are maybe completely unversed in how to deal with someone's private information.
FEIBEL: But federal and state laws already address consumer privacy. And Alysia Greer says navigators learn about it during their training. She fears all this talk from politicians could damage the rollout effort.
GREER: I do think it will scare some people away.
FEIBEL: Justin Giovannelli, of Georgetown University, is tracking efforts by states to regulate navigators.
JUSTIN GIOVANNELLI: It's interesting to note that many of the states that have been relatively reluctant to act and implement the federal health law in many other respects have been fairly quick to adopt these laws and regulations on consumer assisters.
FEIBEL: He says some of the regulations may have a chilling effect, making it hard for navigators to do their jobs.
For NPR News, I'm Carrie Feibel in Houston.
KRISTIAN FODEN-VENCIL, BYLINE: This is Kristian Foden-Vencil in Portland.
Oregon's health insurance exchange webpage has yet to enroll one single person, but a workaround has allowed about 70,000 to secure coverage in Oregon's version of Medicaid.
Kyle Thompson lives in the farming community of Jefferson. He can't afford health care, he says, because his work as a tile cutter evaporated when the economy tanked. But his children qualified for state public assistance, so Oregon had the family's details. After the health care law passed, the federal government gave Oregon permission to send Medicaid applications to families like the Thompsons with incomes less than 138 percent of the poverty level.
KYLE THOMPSON: Me and my wife were just really excited in having the health care come up, because it's not something that has been option for us.
FODEN-VENCIL: Thompson got a letter in the mail, answered a few questions then returned it. Talk that nobody in Oregon has been able to enroll via the health insurance website has Oregon Health Authority spokeswoman, Patty Wentz, a little miffed.
PATTY WENTZ: You know, you've seen some national numbers about how people haven't enrolled in the new coverage available in Oregon. That's not accurate. We have 70,000 people.
FODEN-VENCIL: That's out of the 260,000 the state estimates are newly eligible for Medicaid.
WENTZ: That's often the number one question: Is that real? Can I really get health care coverage? When they hear that they can, they're so grateful. One call center staff told me that when she got one of the forms back, and they had drawn a big heart on it saying thank you for this.
FODEN-VENCIL: Oregon embraced the Affordable Care Act, and wanted the website to be a one-stop-shop for both private insurance plans and Medicaid. Governor John Kitzhaber was recently asked whether that might have been a stretch.
GOVERNOR JOHN KITZHABER: Well, I guess one could argue in retrospect we bit off more than other states. But it was an intentional decision. And once we work out these difficulties, I think the people in Oregon will be ahead of the pack.
FODEN-VENCIL: The public still needs to fill out paper applications instead of use the website to get individual insurance. But the state says the Medicaid letters were so successful another batch will go out soon.
For NPR News, I'm Kristian Foden-Vencil in Portland.
CORNISH: Both of those stories are part of a collaboration among NPR, local member stations and Kaiser Health News.
(SOUNDBITE OF MUSIC)
SIEGEL: This is NPR News.
NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.