MICHEL MARTIN, HOST:
A big deadline is looming here in the U.S. for Americans lacking health insurance. Tomorrow is the last day in most states to buy coverage through the Affordable Care Act or face a $695 fine. More than 11 million people have signed up. But as Carrie Feibel at Houston Public Media explains, there's a big push to enroll people who have not gotten coverage, especially Latinos.
CARRIE FEIBEL, BYLINE: There's football season, hunting season and the holiday season. Overlapping all of these is something decidedly less fun and sexy - open enrollment season.
IRIS GALVEZ: We've been busy this past month.
FEIBEL: Iris Galvez is a health insurance navigator in Houston, helping people enroll in plans through the Affordable Care Act.
GALVEZ: It's the holidays that makes it's hard because, you know, people are, like, well, we'll just put it off. But now we are getting very busy (laughter).
FEIBEL: Recently, Galvez helped Elisia and Cipriano Saenz, a couple from north Houston.
GALVEZ: (Speaking Spanish).
FEIBEL: Signing up can be a chore. You need to gather financial documents and set aside money for the monthly premium. Galvez says some returning customers are angry this year because almost all the coverage plans on the marketplace in Houston are now HMOs.
GALVEZ: This year, they have taken away the PPO. A lot of people are not pleased with that.
FEIBEL: That means they have fewer choices of doctors and hospitals. Still, she tries to focus on the positives - not only avoiding a tax penalty for not being covered but also the peace of mind insurance brings.
GALVEZ: You never know, you fall and slip and break your leg - that's a big bill from the hospital.
FEIBEL: Galvez finished filling out some paperwork for the couple. Elisia Saenz was relieved.
ELISIA SAENZ: We were having a hard time getting into it, so...
FEIBEL: Last year, her husband, Cipriano, did to try to sign the couple up. But he was confused and then suspicious when a government worker called to request more paperwork. He never followed up and the insurance lapsed.
SAENZ: Something had gone wrong or maybe he didn't understand.
FEIBEL: Elisia is 56 and Cipriano is 62. They work as janitors at a charter school and say they can't afford the insurance offered at the school.
SAENZ: It's been years that I haven't been to a doctor or nothing. And now I could go, you know, just get a whole physical and he could do the same. So we're happy that we got this.
FEIBEL: Under their new plan, the federal government kicks in a subsidy of almost $700 a month. The Saenz must pay $363 a month. They also have a $2000 deductible.
SAENZ: They're pretty good, reasonable.
FEIBEL: The Obama administration has increased its outreach this year to Hispanics, running special ads and targeting cities like Houston, Miami and Dallas that have big Hispanic communities. Across the country, 21 percent of Hispanics are uninsured, compared to 9 percent of whites. There are lots of reasons why. Hispanics are more likely to work in jobs that don't offer health benefits. And many are ineligible for the Affordable Care Act or just don't know about it. But in surveys, Hispanics say health coverage just seems so expensive. Elisia Saenz agrees.
SAENZ: They don't make enough money where they work at or, you know, they were self-employed - cutting yards and stuff. And sometimes they can barely probably make it to pay their rent, feed their kids.
FEIBEL: But federal officials say many would qualify for subsidies to buy insurance. But enrollment for 2016 ends tomorrow. For NPR News, I'm Carrie Feibel in Houston.
MARTIN: This story is part of a partnership with NPR, Houston Public Media and Kaiser Health News.
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