(Bloomberg) — Lagging enrollment in public exchange plans among California's Latinos is spurring a new push into communities to sell the state's Covered California program face-to-face.
Many low-wage Latinos fear that using the Patient Protection and Affordable Care Act (PPACA) exchange system could hurt their efforts to become U.S. citizens, or that 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 aren't helping, they say.
The result: Through Dec. 31, Hispanics made up just 20 percent of those who have enrolled in California and identified their ethnicity. That flies in the face of the fact that almost half of California's Latinos are eligible for subsidies to buy private exchange plans, or "qualified health plans" (QHPs), under PPACA.
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 state's 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. "We want to get to a lot more Latinos."
Nationally, about 10.2 million uninsured Latinos are eligible for health coverage under PPACA. They represent 25 percent of the 41.3 million uninsured nonelderly U.S. citizens and other living legally in the United States. In California, they make up about 57 percent of the 6.7 million uninsured.
Younger, healthier
They are important to the success of PPACA both because of their growing political clout and the fact that they're 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."
Daniel Zingale, senior vice president at the California Endowment, a Los Angeles-based health foundation, said 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."
Under the law, undocumented immigrants can't 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."
A link reading "Don't fear if you are undocumented" on Covered California's 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 stick after it wouldn't let her continue unless she added a family member for coverage even though she didn't have anyone to add.
"I was just stuck there," Chavez said in an interview. "I couldn't 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.
