Health insurance exchange aims to increase Latino enrollment

Posted: 12/14/2014 03:50:37 PM PST

Updated: 12/14/2014 03:50:39 PM PST

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By Tracy Seipel

Twice a day, San Jose insurance agent Ruben Villanueva offers KZSF-AM La Kaliente's Latino listeners tips about consumer finance and all kinds of insurance.

This month, he's been reminding his Bay Area-wide audience that Californians need to sign up for health coverage by midnight Monday if they want to be insured on Jan. 1.

It's a tough sell.

'It's not that easy to get them interested and excited and motivated about something like this,' Villanueva said.

Many low-income Latinos say they're just scraping by and can't afford health insurance, while others fear that signing up could alert immigration authorities to the undocumented family members who live with them. And some Latinos seem hesitant to enroll after seeing last month's uproar when President Barack Obama announced his controversial plan to give temporary legal status to millions of illegal immigrants.

'They know the president recently signed something, but they hear people say they don't want them here in our country,' said Maria Bonilla-Giuriato, a public affairs consultant in Salinas. 'It's a mixed message.'

That's a big problem for Covered California, the state's insurance exchange created under the nation's health care law.

Attracting eligible Latinos who didn't sign up during the first enrollment period that ended last spring is key to reaching its goal of 500,000 new members by Feb. 15 -- the deadline for the second open enrollment period under the Affordable Care Act, commonly known as Obamacare.

California's exchange was the most successful in the nation in the first go-around and it wants to continue that momentum.

The exchange enrolled 1.2 million people in private plans and another 2.2 million in Medi-Cal, the state's health care program for the poor. That helped slash the state's uninsured rate from 22 percent to 11 percent.

Prior to the coverage expansions under Obamacare, Latinos, who are 38 percent of California's population, made up about 60 percent of the state's uninsured population.

About 284,000 Latinos got private health coverage this year through Covered California. But the bulk of them signed up after Jan. 1 following Latino leaders' harsh criticism of the exchange's weak rollout strategy for signing up Latinos.

Not only did Covered California woefully underestimate the number of bilingual call center operators and Spanish-language enrollment counselors needed, it also failed to produce paper applications in Spanish until three months into the open enrollment period.

Exchange officials say they learned their lesson.

Over the current three-month enrollment period that ends Feb. 15, about 40 percent of the exchange's $29 million media budget is being directed at the 950,000 Latinos who qualify for subsidized coverage on the exchange but never enrolled, according to Peter Lee, executive director of Covered California. The exchange also has doubled the number of Spanish-speaking enrollment counselors after discovering last year that many Latinos prefer face-to-face interaction to signing up online.

Yet Lee acknowledged that one 'absolutely huge' roadblock is still the fear Latinos in mixed immigration-status families have that their application information will be handed over to the federal government, even though immigration authorities have made it clear they will not use that information to enforce immigration laws.

Villanueva agrees it's a problem. 'I can tell someone that their information will not be used for deportation,' said the veteran insurance agent, 'but they are uncertain.'

To lessen those concerns, Lee this month announced a partnership with leading immigrant rights groups -- he calls them 'trusted voices''-- to spread the word that information shared in health plan applications will be kept secure and confidential.

Among the organizations involved are the Mexican American Legal Defense and Educational Fund and the National Immigration Law Center.

Lee, who last week announced that nearly 300,000 new health care consumers signed up for either a private insurance plan or Medi-Cal in the first 19 days of open enrollment, is confident that the new efforts -- including new TV ads that directly address the fears -- will be reflected in demographic data in the next batch of enrollment numbers to be released in January.

Among those who don't need to be convinced to sign up is Rogelio Cervantes, a guitar instructor in Alum Rock Union School District's mariachi program who works on contract and thus must buy his own health insurance.

Because his annual income is relatively low, Cervantes, 57, this year received a subsidy that allowed him to buy a Kaiser policy for $198 a month.

Cervantes said he knows other Latinos who are eligible for the same kind of deal, but they're afraid of the repercussions.

A survey by the Menlo Park-based Kaiser Family Foundation showed that after the first open enrollment, 62 percent of California's remaining uninsured were Latino. And according to the survey, nearly half of those aren't eligible for health coverage through the exchange or Medi-Cal because they're undocumented.

In addition, 37 percent of Latinos eligible for private insurance or Medi-Cal told pollsters they were worried that enrolling in coverage would call attention to the immigration status of family members'

Bonilla-Giuriato, a health care education appointee in the administration of former Gov. Arnold Schwarzenegger, applauds Covered California's latest strategies for attracting more Latinos. But, she said, plenty of enrollment challenges remain.

This month, she noted, thousands of Latinos will return to Mexico and Central America for the holidays, while many California farmworkers head to Arizona for seasonal work.

She also believes the cost of health coverage remains a huge hurdle for low-income Latinos and that many will opt to pay the minimum $325 penalty for not having insurance.

'People are making low wages and already struggling to survive,' she said. 'When you add it up, health insurance is a lot of money.'

HEALTH CARE ENROLLMENT TIPSHere are some things you need to know about signing up for insurance through California's health care exchange:The second enrollment period is only three months. It started Nov. 15 and will end Feb. 15.If you bought individual health insurance last year and do nothing, your plan will be automatically renewed. If you want to change your plan, you'll need to do so by Feb. 15.If you want your insurance to start on Jan. 1, you must enroll by Monday. If you enroll by Jan. 15, your plan will start on Feb. 1. If you enroll by Feb. 15, your plan will begin on March 1. Shop around. Some plans will be more expensive than last year, others less expensive. The statewide average increase is 4.2 percent.For more information, go to www.coveredca.com. For local enrollment events near you, go to the link 'Find Local Help.'