ROBERT SIEGEL, HOST:
Sunday is the deadline to sign up for health insurance under the Affordable Care Act. A lot of people signed up in Texas last year and insurance brokers took notice. They are aggressively marketing themselves this year. It's a big change because brokers in Texas have had an uneasy relationship with the health care law. Carrie Feibel at Houston Public Media reports.
CARRIE FEIBEL, BYLINE: Bart Franco is spending his retirement in prayer. Behind his house near downtown Houston, he's turned a damp garage into a tiny community church with himself as pastor. He prays for hours every day.
BART FRANCO: To hear the voice of God, not the voice of man and not the voice of the evil one.
FEIBEL: Franco leaves a lot of things in the hands of God, but he didn't do that when it came to health care. He has Medicare, but he wanted insurance for his wife and son. Last year, he tried to enroll them in a plan through the new exchange.
FRANCO: First I called the 1-800 number, and I was on hold for, like, 40 minutes and just hung up, gave up. I'm not going to put up with that.
FEIBEL: Franco then called the insurance company, but he felt the process was rushed.
FRANCO: They just give you an insurance and it costs this much and you only pay $146 - that sounds good, doesn't it? OK, fine. And you're hooked and you don't even know what you have.
FEIBEL: Franco also didn't like the plan's high deductible, which was more than he made in a year. So this time when Obamacare enrollment started, he used a licensed insurance broker.
FRANCO: She connected us on the computer. She showed us everything, showed us a deduction, why we didn't want this and why we didn't want that. So she explained everything.
FEIBEL: His broker is Jo Middleton, and she's president of the Houston Association of Health Underwriters. She says she's heard other stories like Franco's - that last year some people struggled to sign up on their own. Some picked a plan with a deductible they couldn't afford. Others found out later their doctors weren't in the network.
JO MIDDLETON: Buying an insurance policy is not like going online and buying a vacation, you know? It's much more complicated. There are a lot more nuances.
FEIBEL: Some shoppers did turn to government-funded navigators for help, but there are fewer than 500 of them in Texas compared to more than 190,000 health insurance agents. From the beginning, brokers felt left out of the law because the federal marketing focuses on the navigators and the website. But during the second wave of enrollment, insurance brokers and agents are stepping up on their own to tout their expertise. In Texas, brokers held events, put up fliers and even bought television ads.
(SOUNDBITE OF AD)
UNIDENTIFIED MAN: Confused by the sign of our times? The law requires health insurance and enrollment time is limited. Your local licensed health insurance agent will help you understand and enroll on a timely basis.
FEIBEL: Brokers say the health law's impact on them is mixed. Theoretically, the law created a whole new market of potential customers, and agents get paid a commission every time they sign one of those people up for a new health policy. But they also say their commissions have been cut and that's because of the law itself. It dictates how much money insurance companies can set aside for profit and overhead and some companies have dealt with that by cutting the agent's commissions. Marcy Buckner is with the National Association of Health Underwriters.
MARCY BUCKNER: This has just kind of devastated the agent community and has been in place for several years.
FEIBEL: The Association is backing a bill in the new Congress to tackle the problem. In the meantime, Buckner says brokers have had to adjust.
BUCKNER: We've seen some agents who have been able to really work the new opportunities that they've had in the marketplaces and have continued to grow their business and have succeeded very well while others have still been struggling under this cut in commissions.
FEIBEL: And some brokers have switched their focus to Medicare policies or health plans for small businesses. It's too early for any exact numbers on how many brokers stayed in the game or how many people they signed up. What is clear is that more than nine million people have signed up or reenrolled this year with a few days left still before the deadline. And about 1 in 10 of those people is from Texas. For NPR News, I'm Carrie Feibel in Houston.
SIEGEL: And Carrie Feibel's story is part of a reporting partnership of NPR, Houston Public Media and Kaiser Health News.
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