Norma and Rodolfo Santaolalla have always worked but have never had health insurance. When the Arlington, Va., couple tried to apply online for Obamacare coverage, it was just too confusing.
"I didn't understand about the deductibles and how to choose a plan," said Norma Santaolalla, 46, who cleans houses for a living and whose husband is a handyman. "It's difficult. It's the first time we've done that. That's why we came here to ask them to help us."
"Here" was the Arlington Mill Community Center where help was available on a recent Saturday as part of a national effort to boost Obamacare enrollment, especially among Latinos.
Latinos represent about a third of the nation's uninsured and for a number of reasons, signing them up has been harder.
As of Jan. 16, just 10% of those who had signed up for plans in the 37 states served by healthcare.gov are Latino ýýý up slightly from 7% during the first few months of last year's enrollment, despite concerted efforts to reach them, according to government data.
Experts caution that those numbers are reported by applicants and there's no requirement that anyone signing up for coverage state their race or ethnicity. Nonetheless, government and pro-Obamacare groups have stepped up their efforts through media campaigns and emphasized the kind of in-person assistance the Santaolallas and many other Latinos seem to prefer.
Nearly a third of the ACA's media budget this year is focused on Hispanic media, tripling the 10% spent on reaching Latinos last year, according to Health Secretary Sylvia M. Burwell.
Providing in-person assistance, however, takes time. A session can easily run 90 minutes to two hours, and several meetings are often needed to explain how insurance works and what the options are. Even though applicants may qualify for tax credits, many will still have to pay a monthly premium. And people who have gone without insurance for years might not feel the need to buy it.
Still, since October 2013, 2.6 million Latinos ages 18 to 64 gained insurance through the health law, according to federal officials. As of last June, the share of Latinos without health insurance dropped from 36% to 23%, with the highest gains in states that adopted Medicaid expansion, according to a Commonwealth Fund analysis. That's important to the success of the overall health reform, because uninsured Latinos tend to be young and healthy. They are likely to use fewer medical services and will help offset the cost of sicker people in the insurance "risk pool."
Lusmila Morales, 53, also hoped to obtain ACA coverage when she sought help at Legal Services of Northern Virginia. She sent in a paper application last year but never heard back and wanted to try again. She brought along her 17-year-old nephew to translate when she came to enroll in late January.
The Falls Church resident is applying for health insurance "out of necessity," said her nephew, Daniel Palacios. She has arthritis but can't afford medication. She needs a mammogram and a physical but can't afford the tests.
But Morales couldn't complete her application because she forgot her green card, which proves she is a lawful permanent resident of the United States. She would have to come back.
One of the most stubborn obstacles is the widespread fear in the Latino community that those who are eligible for coverage might endanger others in their family who are undocumented. That concern persists even though President Obama and others have vowed that no information on a health law application will be used for deportation purposes.
"You don't want to be the family member that because you signed up for coverage, you're getting your grandmother, your uncle or your parent deported," said Anthony Wright, executive director of the group Health Access California, a healthcare consumer group.
The patchwork of state-based and federally based exchanges can also cause confusion, with some state governments more welcoming than others when it comes to Latino outreach.
Just over half of states have expanded their Medicaid programs. If all states participated in the health law's Medicaid expansion, 95% of uninsured Latinos might qualify for Medicaid, the Children's Health Insurance or tax credits to help lower the cost of health insurance on the federal and state marketplaces, according to federal estimates.
The fact that this year's enrollment period is three months shorter than last year's further complicates enrollment efforts. Those who work with the Latino community say because so many have been uninsured for so long, it will take longer to reach them.
Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.
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