DALLAS HOUSTON SAN ANTONIO

TOP MEMBERS HAVE LED THE CHARGE. Fighting for Medicaid Expansion; Ramping up Healthcare Enrollment;

Holding Texas’ Failed Leadership Accountable;

Surpassed Target

Enrollment Numbers

Organizeed and activated

tens of thousands.

Countered right-wing

rhetoric and numerous

barriers

603,922 Outreached

57,816 Conversations

9,309 Participants at

ACA Events 218 Press Clips

Publicly confronted Gov.

Perry 6 times

31,214 Committments to Vote in 2014

5,387 Committments

to Enroll

96,179 Actions Taken

Grew Members and Supporters

to 48,000 193 Trained

Spokespersons

“Today’s enrollment figures are more proof that Texans are ready and willing to push past the barriers that Gov. [Rick] Perry has put in the way of the new healthcare law” TOP Executive Director Ginny Goldman

February 10, 2013 Fort Worth Star-Telegram

TOP HEALTHCARE CAMPAIGN OBJECTIVES

Since 2012, TOP has been leading the charge in publicly calling out Governor Perry’s failed leadership and political opposition to implementing the ACA, specifically his stance to reject the $100 billion in federal funding to expand Medicaid-- while also educating the public on enrollment, building energy towards and throughout the open enrollment period October 1st 2013 to March 31st 2014. Our objectives in this campaign are: Work to ensure millions of uninsured Texans have access to newly available

programs providing access to health coverage Expose Texas’ failed leadership and blatant disregard for low income-minority

communities health care, and Engage and activate thousands of low propensity voters of color on the issue of

health care in 2013-2014. TEXAS HEALTH COVERAGE: BY THE NUMBERS

6.2 Million Uninsured

3.1 eligible for ACA Marketplace tax credit

1.5 eligible for expanded coverage

under Medicaid Expansion

40% of Uninsured concentrated in major urban areas: Bexar, Dallas/Tarrant and Harris County.

Exchange Eligible by County Total Uninsured Total Left Behind Due To Rejection of Medicaid Funds

Harris 599,275 1,025,922 110,243 Dallas 384,905 601,492 64,735

Tarrant 224,002 415,186 47,996 Bexar 171,168 396,475 52,484

BACKGROUND The Affordable Care Act (ACA) or “Obamacare” was made law to address the societal, economic and moral issues associated with millions in American communities without access to affordable healthcare. Two major components of the ACA are the expansion of state Medicaid programs and state or federal-based insurance exchanges. The highly politicized environment around this law has led to many red states, their governors and legislatures opting out of any positive participation in either Medicaid expansion or the health care exchanges even if to the detriment of their state’s health.

Texas is one of these red states unabashedly rejecting everything Obamacare much to the dismay of healthcare professionals, hospitals, and patients alike. Texas, alone, has over 6 million without health coverage – ranking last in the nation in health care coverage. Because of the current restrictive Medicaid program 1.5 million Texans could gain access to affordable health care if the state program was expanded. However, without expanding Medicaid, over a million Texans will fall into the coverage gap between eligibility of Texas’ current Medicaid program and the eligibility for premium subsidies through the healthcare exchange. ACA will however mean coverage for 3.1 million uninsured Texans eligible for the Federal Exchange.

Texas Governor Rick Perry has been one of the most prominent and aggressive opponents of the Affordable Care Act from its inception early in 2009. Perry, along with other Texas state leaders, has used opposition to the Affordable Care Act to bolster their standing with the extreme Tea Party wing of the Republican Party in Texas.

Texas was one of the first states to legally challenge the Affordable Care Act under the direction and guidance of Attorney General Greg Abbott, filing arguments against it in the US Supreme Court. Following Supreme Court approval of the Affordable Care Act, rather than find a path for Texas to participate in the expanded healthcare options for Texas citizens as was done by Governors in many other states, Rick Perry, Greg Abbott, Ted Cruz and the Texas ring wing have become even more active critics of the Affordable Care Act and has adamantly refused to allow Texas to participate in Medicaid expansion.

Opposition to Medicaid expansion and ACA as a whole cannot be substantively justified, particularly in Texas. Texas has the largest number of uninsured residents of any state in the country, with nearly one quarter of Texans without any type of health insurance. Texas nonpartisan academic leaders, civic leaders, healthcare providers and business leaders have confirmed that Texas’ failure to participate in expanded Medicaid threatens not only the health and wellbeing of millions of Texans but overall economic health and future job growth as well. Support for access to affordable healthcare is an opportunity for broader coalitions of non-traditional allies and partnerships to develop like never before in Texas. In addition to progressive coalitions joining forces to ensure the success of Obamacare, health professionals, academics, economists, business and labor uniting around healthcare has significant implications for broader landscape change in Texas.

“He had his mind set already [on Medicaid expansion]. He wasn’t really open to new ideas.” Dallas TOP member Connie Paredes after meeting with Gov. Perry

May 22, 2013

Dallas Morning News

BEATING THE ODDS: TOP SUCCESS STORIES

Luis Veloz is a young man who has been through a lot in his 19 years. Luis had been accepted to Southern Methodist University in Dallas majoring in Human Rights, and, because of his stellar grades, was able to get a partial scholarship valued at $150,000 to attend the university. Luis was forced to withdraw from school so he could work full time, along with his brothers to help their parents with mounting debt from medical bills. According to Luis, "Healthcare is not a privilege, it is a basic human right essential to the prosperity of society." Luis enrolled in the Marketplace and now has health care for the first time in his life.

Cecilia Fontenot is a part-time accountant in her early 60’s. She is a widow living on a fixed income in Houston. Cecilia was uninsured before the Affordable Care Act and tried to stay healthy by exercising and eating the right foods. Cecilia is plagued by numerous health problems, including diabetes, high blood pressure and high cholesterol. A year ago, Cecilia detected a lump on her breast. Her doctor recommended a digital mammogram, but she was not able to afford the more involved test. She signed up through the Marketplace this enrollment period, and was able to save $417 a month on her new plan. She has been to the doctor twice since she enrolled.

BROAD OUTREACH AND EDUCATION From the lead-in to enrollment period, to October 1st Press Launch to the madness of the final push in March, the Texas Organizing Project its members and supporters have been knocking on doors, making phone calls, hosting weekly workshops to inform the community of new healthcare options available to them because of the Affordable Care Act as well as connecting them directly to in-person assisters who can walk them through the application and enrollment process.

Enrollment Period bookended by major events: In September 800 Texans crowed into halls to hear about their options, in

March, over 1,000 came to get enrolled!

By March 29th, completed enrollments had reached 108% of HHS target goal for Houston.

EXPOSE & HOLD ACCOUNTABLE: Texas’ Failed Leadership Governor Perry announced that he would reject $100 billion for Texas to expand health coverage to the working poor in the state. This left over one million hardworking Texans, families, moms and dads without affordable healthcare options. TOP members wanted to make sure Governor Perry heard from impacted hardworking Texans about his decision, and so, hardworking Texans followed him---from the State of the State Address in early 2013, a fundraiser breakfast in Washington DC, to Chamber luncheons….working uninsured made their voices heard…..and Governor Perry asked us to his office to meet in person and talk it over. The rejection of federal dollars to expand healthcare was the first of many barriers placed in front of Texas families and access to health coverage:

1. The refusal to establish a Texas health insurance Marketplace

2. The refusal to outreach and education Texans about their health coverage options under the ACA.

3. Additional and unnecessary state regulations on navigator or assister entities and individuals

4. Continuation of negative rhetoric and misinformation.

“The rules released today will still impose unnecessary burdens on health insurance navigators, but they are better than the onerous regulations recommended by Governor Perry and Attorney General Greg Abbott, whose main interest seems to be scoring political points, not helping Texans get health care. It’s clear that the Texans who spoke out – including the dozens of TOP members who attended a public hearing in December – have helped make a difference.”

TOP Executive Director Ginny Goldman January 21, 2014, Texas Tribune

BUSTING PERRY’S MYTH: Countering right-wing message with the Texas reality.

Governor Perry said: "We judge success by the number of people that have a job... Go buy (health) insurance, or be in a company that delivers that health care for them..”

Attorney General Abbott said: “Just because someone may be uninsured does not mean they don’t have access to healthcare…” (Texas Tribune, Aug. 20, 2013)

Linda Berman says: “I knew I had no money to pay for [a recent hospital visit] but had I not [paid out of pocket], they wouldn’t have saved my life. People without insurance don’t get preventative care. You don’t die of diabetes, you die of complications.” (Texas Observer, 2/7/2014)

193 Identified and trained Spokespersons to tell

their story about access to healthcare in Texas.

“We came to this country, and we are legal and we work really hard. Why we don’t have the same opportunities as the others?” Houston TOP Member Gladys Arbila on Medicaid Expansion

October 2, 2013, New York Times

“I just take something over the counter or wait till I can't take [the pain] anymore. I found out that Rick Perry had denied Medicaid. And I thought, ‘What's going to happen with me now?’”

Dallas TOP member Claudia Martinez January 8, 2014, The Atlantic

“I have to scrape by as it is. By the time I pay rent, lights and water, there's not much left over. Sometimes, I don't eat so my kids can eat. I'm on the borderline. If Perry had accepted the (Medicaid) money, I would have qualified. I wouldn't have to be struggling.”

San Antonio TOP member Irma Aguilar January 25, 2014

San Antonio Express-News

DEVELOPING KEY PARTNERSHIPS In Texas, Latino families are disproportionately impacted in the access to affordable health coverage. 53% of the uninsured in Harris County alone are Hispanic or over 500,000 people. Spanish media markets reach over 4 million Texans between San Antonio, Dallas and Houston areas. Thus, Spanish media is well positioned to get accurate and pertinent information directly to the most impacted, uninsured community.

Univision is the most watched broadcast media and they were instrumental in getting accurate information to Texas families. During the enrollment period TOP co-hosted 8 telathons with Univision, including 1 large statewide telethon in conjunction with Austin, Dallas, Houston, and San Antonio Univision stations at which 40 TOP volunteers received over 2,000 calls from the four cities. In addition to the successful telathons, Univision and TOP worked closely to get accurate information through both radio and television interviews, promote ACA workshops and major enrollment events. National Univision profiles TOP leader Univision led the coverage and in depth reporting about the disparity in health access in the Latino community with the documentary “Estado Critico” or “Critical State” that tracked the millions of Americans getting left without access to health care and narrowed their view to focus on Texas, particularly around the compelling story of TOP community leader Luis Veloz, who had to withdraw from school at Southern Methodist University (SMU) because his family was strapped with $200,000 in medical debt after his brother and father were injured in construction work, where they worked without health insurance. (“The healthcare system in the United States does not function well and needs a change.” From National Univision Documentary Estado Critico or “Critical State”).

During the enrollment period, TOP also worked with other Spanish and English

broadcast media stations in the 3 largest media markets which expanded TOP’s reach to an additional nearly 6 million Texans in order to engage and educate Texans about the benefits of

the Affordable Care Act via telathons and webchats. Combining all telathons and webchats, TOP volunteers answered questions and reached an additional 7,000 Texans.

COMMUNITY PARTNERSHIPS

TOP played and continues to play a leading role in statewide advocacy as well as regional enrollment coalitions in Dallas, San Antonio and Houston linking individuals from our broad outreach and education activities to in person assisters of the varied navigator and assister organizations. During 2013 Legislative Session TOP tracked a number of legislative proposals during the regular session regarding Medicaid expansion -- activating our members and allies to testify at key committee hearings as well as generating thousands of calls and emails to their legislators. In our role with the Texas Left Me Out initiative, TOP is activating impacted Texans getting left behind due to the lack of expanding Medicaid in Texas as well as getting a head start on legislative advocacy.

MOVING FORWARD: The outreach and education achieved in our healthcare campaign will lead to local policy solutions to address those left in coverage gap as well as activating Texans to vote in upcoming 2014 election.

• Prepping for the next enrollment period • Prepare to win Medicaid Expansion in 2015 • Target 280,000 voters of color in Texas. • Organize Texas Left Me Out committees in key legislative

districts.

TOP NEWS CLIPS