HOUSTON -- At Legacy Health Community Services in Montrose, Dr. Lia Rodriguez spends her workdays talking to patients about their healthcare.

So perhaps it s telling that one subject that s never arisen between her and her patients is one of the most furious public policy debates of our time.

I actually have not been asked once about the Affordable Care Act, Rodriguez said.

With just six weeks left before one of the most critical dates for the implementation of Obamacare, professionals and volunteers trying to spread the word about the new health care insurance program are encountering everything from confusion to apathy to ignorance.

This is part what prompted a visit to Houston by Kathleen Sebelius, the nation s secretary of Health and Human Services.

This is no longer a political debate, Sebelius said. We call this the law of the land.

She is the Obama Administration s point woman on the nation s new health insurance plan.

Her appearance came exactly 43 days before what you could call opening day of Obamacare for millions of uninsured Americans. On Oct. 1, open enrollment begins in the online marketplace of insurance carriers.

On Oct. 1, there ll be a new online shopping market, with Texas plans offering coverage for Texans, Sebelius said. So (it s) insurance companies who offer insurance coverage for Texans. It s not a government program, it s Texas-based private insurance.

Most Texans like most Americans won t see any direct change in their coverage, because most people are already insured. However, about 23 percent of all Texans are uninsured, the highest percentage of any state in the nation.

The open enrollment period runs through March 2014. After that, uninsured Americans will be subject to tax penalties that escalate over a period of years. The fines vary based upon income, but the minimum penalty begins at $95 in 2014, $325 in 2015 and scales up to $695 in 2016.

Sebelius spoke before a group of trainees learning how to convince young people to sign up for health insurance under the new program. Younger consumers, who are less likely to get sick than older consumers, are an especially important component of the plan. Their premiums will help offset the generally higher health care costs of older people.

What works well in an insurance market is a big pool of individuals, Sebelius said. And they are using their insurance coverage a bit differently. So having young and healthy people who may use less health services some years than others or some of them get sick, but fewer of them get sick than people who might be 64 or 65 is good for the insurance market.

Sebelius declared the political debate over the health care plan finished, but opponents obviously disagree. Gov. Rick Perry, whose strident opposition to the plan led him to reject an expansion of Medicaid, released a statement through his office ridiculing a video contest Sebelius unveiled in Houston to help promote enrollment.

If Obamacare were sound health care policy, Secretary Sebelius wouldn t have to resort to video contests and prizes to tempt people to sign up, the statement said. Texans are already subject to too much costly and burdensome federal regulation, and Obamacare only makes the problem worse.

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