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RAMIT PLUSHNICK-MASTI, Associated Press

HOUSTON (AP) — Health care workers and officials in Texas on Monday rushed to sign people up for insurance plans, even after receiving a one-day extension on a deadline for customers buying coverage under the new federal health care law to have their plans kick in Jan. 1.

In Dallas and Houston, hundreds of people trained to assist with enrollment worked the day before Christmas Eve, forgoing a vacation day that many others enjoyed.

Open enrollment continues through March 31, but for those who want their insurance plans to go into effect on New Year's Day, Monday was supposed to be the last day to enroll in Texas and many other states. But the federal agency overseeing the rollout, expecting a rush of people to enroll at the last minute, extended the deadline through Tuesday, giving them an extra day to choose a plan.

The grace period was the latest in a series of pushed-back deadlines and delays that have marked the rollout of the health care law.

"We expect, just like we see on all deadline days, that we'll see a crush of people," Dallas County Judge Clay Jenkins told The Associated Press, who encouraged people to get online or call immediately to enroll.

"Don't wait till late afternoon or nightfall when the biggest procrastinators will be clogging up the phones and the websites," Jenkins said.

About 25 percent of Texas residents, or some 6 million people, lack health insurance. It is the highest rate in the nation. Caring for those people costs millions of taxpayer dollars annually, officials said. So the opportunity to get them health insurance through President Barack Obama's signature law is key to lowering those costs, Jenkins said. About 14,000 Texans enrolled for coverage in October and November.

In Dallas and Houston, health care workers and nonprofit groups doing outreach to the uninsured held dozens of events in recent days.

Many people who turned out in recent days were eager to enroll for coverage that would begin Jan. 1, said Mario Castillo, who is leading outreach and enrollment efforts in a 13-county region surrounding Houston for Enroll America, a nonprofit working to get people coverage under the new law.

Many people wrongly believed they also had to pay by Monday for Jan. 1 coverage, so part of the job was explaining that payments were not due at the same time, Castillo said.

Castillo said to avoid confusion the group would continue viewing Monday as the deadline. He said the group was not planning any last-minute events due to the extension.

The HealthCare.gov site had a disastrous, glitch-prone debut in October, but the government reported on Twitter that it was running smoothly Monday morning.

Once the website began working properly, though, late last month, there was a significant uptick in those seeking to enroll, said Sharon Phillips, an executive vice president at Dallas' public health system, Parkland Hospital, a facility that sees most of the area's uninsured.

Very quickly, she said, there were people waiting outside to enroll before the campus officially opened at 7 a.m. First, it was 20, then about 50, and by last week there would be 75 people waiting outside, Phillips said. On Monday, there was about a 10 percent increase from last week.

"It's not a huge increase, and I think because it's almost Christmas," Phillips said.

Enrolling Texans is crucial to the law's success. In Dallas County alone, Jenkins said, taxpayers spent some $685 million in 2012 to care for those who lack insurance, much more than the $430 million the county collected in hospital taxes.

Texas Gov. Rick Perry, like many other conservative Republicans, has staunchly opposed the law, which they say is expensive and burdensome. The state deferred to the federal government to set up Texas' enrollment website, and it rejected federal funding to expand Medicaid. As a result, more than a million people could remain uninsured because they will not qualify for subsidized insurance under the exchange but will also earn too much to qualify for Medicaid in its current configuration in Texas.

Still, every person that gets coverage will help decrease the strain on the system.

"It's key from a public health standpoint, and it's the most important thing we can do economically to keep our taxes low and to keep our economy strong," Jenkins said.

 

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