TOPICS > Health

Language barrier, immigration status keep some Latinos from health care enrollment

February 5, 2014 at 6:25 PM EDT
As the largest uninsured ethnic group in the country, Latino Americans are considered key to the success of the Affordable Care Act. In California, enrollment numbers continue to lag despite tens of millions of dollars spent to reach Latinos, who represent more than half of the 7 million who lack coverage in that state. The NewsHour’s Cat Wise reports.
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JUDY WOODRUFF: As states across the country continue to grapple with the rollout of the Affordable Care Act, much attention has been placed on the Latino population, because they represent more than a third of the uninsured in the U.S. Many eyes are on California, where there’s been a big marketing effort directed at the Latino community.

The NewsHour’s Cat Wise has our story.

CAT WISE: It’s a typical busy day at La Clinica de La Raza in Oakland, Calif. The federally funded community health organization serves more than 85,000, mostly low-income Latino patients, each year.

Latinos represent more than half of California’s 7 million uninsured. Both here and nationally, Latinos are considered key to the overall success of the Affordable Care Act, because they are the largest uninsured ethnic group in the country, and they tend to be younger and healthier, which can help offset premiums for older, sicker enrollees.

In the months leading up to the October launch of the Affordable Care Act, there was a big push in California to get Latinos educated about the new law. Tens of millions of dollars were spent on ads targeting the community around the state.

But La Clinica CEO Jane Garcia says a lot of educational outreach is still needed.

JANE GARCIA, La Clinica De La Raza: If you look at, historically, who have been the uninsured, it is the Latino community. So it’s not a big surprise to us that people don’t understand what a deductible is or what a co-pay is, let alone the comparison of the health plans that has to happen.

CAT WISE: La Clinica’s staff have provided personal application assistance to 900 patients in recent months, but only about 25 percent have actually enrolled in Covered California, the state’s insurance exchange, or in Medi-Cal, the state’s version of Medicare.

Statewide, Latino enrollment numbers are also lagging. New figures released by Covered California show just 74,000 enrollees through December described themselves as Latino, far fewer than the estimated 1.2 million who are eligible for premium subsidies.

At a recent Covered California board meeting in Sacramento, the issue was front and center.

PETER LEE, Covered California: With regard to the Latino enrollment, this is an area we know we need to do more.

CAT WISE: Covered California executive director Peter Lee says he’s pleased with the overall enrollment numbers in the exchange so far, more than 600,000, but he acknowledges that they got off to a slow start with the Latino community.

PETER LEE: Like many of the exchanges around the country, our customer service has not been great, but we’re doing a lot of things to improve it. This Affordable Care Act is brand-new. This is the first open enrollment in history. We’re learning a lot as we go to make sure we get as many Latinos enrolled.

JANE GARCIA: The Covered California board doesn’t have a representative that either is of Latino descent or understands how to market this population, and I think that has been the reason why they have failed at reaching Latinos.

CAT WISE: State Senator Norma Torres, who represents a predominantly Latino district near Los Angeles, believes the agency’s problems go way beyond their marketing efforts. She says the customer service for primarily Spanish-speaking Californians has been, well, awful.

NORMA TORRES, Calif. State Senator: What I believe has been a major obstacle that this group has not signed up is, number one, the application wasn’t made available to them in Spanish until this month. We’re talking about January 2014.

So, when a Spanish speaker calls the hot line, the message was also in English, and that was one of the very first changes that they made as a result of my office pushing back that they needed to improve their customer experience for Spanish speakers.

CAT WISE: Senator Torres and her staff have also been closely tracking the Covered California Web site and say there have been Spanish translation problems since it launched.

Alex Barrios is Senator Torres’ communications director.

ALEX BARRIOS, works for California State Senator Norma Torres: As a Spanish speaker, one of the first challenges I have when I go to the Web site is, I go to www.CoveredCalifornia.com, which is the Web site that the Spanish-language advertisement tells me to go to. The first thing I see is an English page. So, the page is in English, even though the advertisement told me in Spanish that this is the Web site I should go to. So that’s really hard for me.

CAT WISE: Covered California officials say they have been working diligently to get translation problems fixed, both on the Web site and phone hot line.

But another problem looms large for those anxious to see more Latinos enrolled. La Clinica’s Jane Garcia says many patients are reluctant to reveal information about undocumented family members during the enrollment process. Only citizens and legal residents are eligible for health coverage.

JANE GARCIA: One of the biggest issues that we — our enrollers have faced is the question of immigration status. Many, many of our patients are in mixed immigration status families.

I think at this point, we really need a high-visibility person, whether if it’s our governor, whether it’s our senators — our president, if he could make a statement that people could stand on that says, this will not have consequences to your immigration application, I think that would go a long ways toward easing people’s minds.

CAT WISE: For their part, Covered California officials are trying to reassure people the information they share will not be used against them.

PETER LEE: We have been working to get the word out that we have a rock-solid, you know, letter from the Homeland Security saying information on immigration, which we need for eligibility purposes, will only be used for one purpose, eligibility for health care.

CAT WISE: Lee says boosting the Latino enrollment numbers over the coming months is a top priority. Hiring is now under way for 350 mostly bilingual call center counselors. And a new $155 million federal grant will help the state with overall outreach efforts, including new ads targeted at the Latino community.

GWEN IFILL: California officials plan to release a demographic breakdown of the state’s Medi-Cal enrollment figures later this month.