It has been a year since Mandy Howard underwent treatment for severe anemia.


Although she needs a blood transfusion and other therapy every six months, she couldn’t schedule a recent appointment, she said.


“I don’t have health insurance,” said Howard of Lancaster, blaming expensive rates through her employer’s health plan. “I turn pale. My fingers turn blue. I’m not as healthy as I should be.”


On Saturday, she was among a crowd lined up outside the Kay Bailey Hutchison Convention Center to learn more about the new Affordable Care Act.


Downtown Dallas was the final stop for the Be Covered Texas information forum, sponsored by Blue Cross Blue Shield of Texas.


Earlier this month, the campaign traveled to Houston, drawing about 4,600 people. Attendance in Dallas was more than twice that. Even before the fair ended, the turnout was estimated at nearly 10,000.


Free flu shots and screenings for diabetes, cholesterol and dental care were also available Saturday, though those services weren’t connected to insurance enrollment.


People got help navigating the Affordable Care Act’s online marketplace, healthcare .gov, and learned about their insurance options.


Since the enrollment period opened Oct. 1, the marketplace’s website has been plagued with technical problems. Some in line Saturday said hearing about frustration with the site had kept them from trying it.


But Dr. Dan McCoy, chief medical officer for Blue Cross Blue Shield of Texas, said the health care provider was confident the marketplace will work in the long run.


“With any new system, there’s going to be a little ramp-up,” he said. “It’s a transformative day in American health care. People have an opportunity to have an insurance card in their pocket for the first time.”


The Obama administration recently announced that Americans who buy insurance through the online marketplace will have an extra six weeks to obtain coverage before risking a penalty.


Under the 2010 health care law, most Americans are required to have insurance by Jan. 1. The extension means those who buy coverage through the state and federal exchanges have until March 31 to sign up.


McCoy is hoping for strong sign-ups in Texas, which has one of the largest uninsured populations. But he said it’s too soon for the insurance company to give specific numbers on applicants.


“The biggest challenge right now is 4 out of 10 Americans don’t even know this is the law of the land,” McCoy said.


Blue Cross Blue Shield is marketing 18 insurance plans in Dallas-Fort Worth, where about 30 percent of Dallas-area residents are uninsured, he said.


Among them is Patricia Reyes of Palmer, who said she often attends free health events such as Saturday’s event to get treatment for herself and her husband and three children.


Reyes, who has hypothyroidism, said her husband works as an electrician but she’s unemployed right now, so they face difficult financial choices.


“We either have insurance or eat,” she said.


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