(Bloomberg) Lagging enrollment in Obamacare among Californias Latinos is spurring a new push into communities to sell the states program face-to-face.
Many low-wage Latinos fear that going on public assistance could harm their efforts to become U.S. citizens, or enrolling could lead to the deportation of undocumented relatives who live with them, according to community activists. At the same time, glitches on the insurance exchange website and a lack of Spanish-speaking counselors on its telephone banks arent helping, they say.
The result: Through Dec. 31, Hispanics made up just 20% of those who have enrolled in California and identified their ethnicity. That flies in the face of the fact that almost half of Californias Latinos are eligible for subsidies under Obamacare. With a March 31 deadline looming for mandated insurance coverage, a new push has begun to sell the program in community centers, instead of through the states exchange website or telephone lines.
The strategy depends on in-person assistance, as opposed to telling them to call our call center or going to the website, said Santiago Lucero, a spokesman for Covered California, which runs the states independent Obamacare exchange. We want to get to a lot more Latinos.
Nationally, about 10.2 million uninsured Latinos are eligible for health coverage under the Affordable Care Act of 2010. They represent 25% of the 41.3 million uninsured nonelderly U.S. citizens and other living legally in the U.S. In California, they make up about 57% of the 6.7 million uninsured.
Younger, healthier
They are important to the success of Obamacare both because of their growing political clout and the fact that theyre younger and healthier as a group than the uninsured generally. That makes them less costly to insurers aiming to offset medical payments for older enrollees while keeping premiums low.
Covered California, which recently secured a $155 million federal grant, is planning to add 350 representatives, including bilingual workers, to its service center by the end of March, with about 250 beginning training this week. The organization has also sent a million mailers to homes, with the vast majority going to Spanish-speaking families, Lucero said.
Latinos would rather put a face to the application process, Lucero said in a telephone interview. That is key for them to enroll. We never said that we were going to enroll them all by March 31. This is a two- to three-year goal.
National beacon
Daniel Zingale, senior vice president at the California Endowment, a Los Angeles-based health foundation, said the ongoing effort to recruit Latinos is important both to the state, and to the message being sent out nationally.
California has led the nation in the successful implementation of Obamacare, Zingale said in a telephone interview. By proving it can work here, that will be a beacon to the nation. On the other hand, if we stumble, that creates even more problems for the embattled law.
The biggest problem is that a lot of people, new immigrants to this country, have a mistrust of government, particularly when they see families being divided and deported, Zingale said.
Under the law, undocumented immigrants cant get coverage. It also requires that those seeking coverage state their immigration status and provide information about members of their household to determine eligibility.
In October, U.S. Immigration and Customs Enforcement, a division of the Department of Homeland Security, said in a memo that it does not use information about such individuals or members of their household that is obtained for purposes of determining eligibility for such coverage as the basis for pursuing civil immigration enforcement action.
Dont fear
A link reading Dont fear if you are undocumented on Covered Californias Spanish-language website connects to a page that explains this policy and connects to the memo.
Still, there remains a great deal of suspicion about talking to the government at a time when problems with the Covered California website, long wait times on the Spanish-language line to enroll by telephone and a shortage of Spanish-speaking counselors remain an issue, Zingale said.
Juanita Chavez, 43, a development associate from Bakersfield, California, said she began trying to enroll in a health insurance plan on the Covered California website in October. She got stuck after it wouldnt let her continue unless she added a family member for coverage even though she didnt have anyone to add.
I was just stuck there, Chavez said in an interview. I couldnt figure out how to get beyond that.
Chavez, who has autoimmune hepatitis and had a liver transplant in 2001, put her application on hold and tried calling the helpline. There she experienced long wait times or a recording saying the lines were busy and to call back later.
Ive never had less than an hour-and-45-minute wait to talk to someone, Chavez said. Who has time for that?
Chavez, who supports Obamacare, finally got through to the call center in early January and enrolled for a plan after an hour-and-50-minute wait. She later found out she was ineligible for Covered California coverage because her work offers health insurance. She said she thought she had a choice between Covered California and her work plan. Her work plan doesnt let her stick with her existing doctors.
They need to have more staff and they need to fix the website and make it easier to use, Chavez said.
Nationwide, challenges in enrolling Hispanics also include a lack of access to computers, low-income families who cant afford the monthly premiums and states that arent expanding Medicaid, said Steven Lopez, senior health policy analyst at National Council of La Raza, a Washington-based Hispanic advocacy group.
Mayra Alvarez, associate director at the office of minority health at the Department of Health and Human Services, said California isnt alone in struggling with the best ways to bring Obamacare to Latinos.
A third of Latinos in the U.S. dont have access to health insurance, half dont have access to a doctor and a quarter are eligible for Obamacare, she said. While Alvarez said her agency doesnt have numbers on how many Latinos have enrolled because applicants arent required to report their ethnicity, shes aware that extra effort is needed.
Informing Latinos about the program has involved having to explain co-pays, premiums and the other mechanics of insurance plans, Alvarez said in a telephone interview.
