When the ACA was passed in 2010, Ana Maria Garza Cortez could hardly believe it. She’d spent decades trying to help poor people in San Antonio get health care. She knew the barriers they faced because she’d faced them too. She’d grown up in West Side housing projects, and her family never had health insurance. She and her seven siblings didn’t go to the doctor when they were sick. “That was a luxury,” Cortez says. “My mom loved us, but we were poor. She would wait to see if whatever we had would go away.” If it didn’t, she would take them to the neighborhood clinic or, more often, the emergency room. Since Cortez graduated from Our Lady of the Lake University, in 1990, she has worked with nonprofits, usually in health care. She serves as the vice president of development and marketing at CentroMed, one of the city’s sliding-scale, safety net clinics, with 23 locations in the area, many in the city’s poorer neighborhoods. She became one of the leaders of EnrollSA, along with Guajardo and Joe Ibarra, the deputy state director and operations manager at Enroll America. Among the city’s health care advocates, Cortez is admired for her energy and passion. “We call her ‘Santa Maria,’ ” Guajardo says. “She lives for the community. It’s in her bones.”
Now that President Obama had pushed through a law making health insurance available, at least in theory, to everyone, Cortez was elated. She knew Texas needed help—the state had five million uninsured residents, more than any other—and her hometown especially so. Officials figured there were 300,000 or so uninsured in the city and surrounding Bexar County. Latinos make up 60 percent of the San Antonio population, but 75 percent of the city’s uninsured. On the South Side, which has a significant Latino population, rates of diabetes, hypertension, and obesity were higher than average. For generations, says Santos Hernandez, who grew up in the Rio Grande Valley and now works as an application counselor at CentroMed, many in the poor Latino population, rural and urban, have had a three-step system for dealing with illness. “First you go to church, light a candle, and pray. Second, you see a curandero. Finally, you borrow money and take your kid to the doctor.”
In Texas Monthly, Michael Hall surveys the Texans whose health has dramatically improved after receiving medical coverage through President Obama’s Affordable Care Act, and discusses the group who labored to get them enrolled. The question that lingers now is: what will happen if the ACA gets repealed?