The nation’s largest minority group risks being left behind by President Barack Obama’s health insurance overhaul.
Hispanics account for about one-third of the nation’s uninsured — and 62 percent of uninsured Texans — but they seem to be staying on the sidelines as the White House races to meet a goal of 6 million sign-ups by Monday.
Latinos are “not at the table,” said Jane Delgado, president of the National Alliance for Hispanic Health, a nonpartisan advocacy network. “We are not going to be able to enroll at the levels we should be enrolling at.”
That’s a loss both for Latinos who are trying to put down middle-class roots and for the Obama administration, experts say.
Hispanics who remain uninsured could face fines, and the government won’t get the full advantage of a group that’s largely young and healthy, helping keep premiums low in the new insurance markets.
“The enrollment rate for Hispanic-Americans seems to be very low, and I would be really concerned about that,” Brookings Institution health policy expert Mark McClellan said. “It is a large population that has a lot to gain … but they don’t seem to be taking advantage.”
McClellan oversaw the rollout of Medicare’s prescription drug benefit for President George W. Bush.
The Obama administration says it has no statistics on the race and ethnicity of those signing up in the insurance exchanges, markets that offer subsidized private coverage in every state. Consumers provide those details voluntarily, so federal officials say any tally would be incomplete and possibly misleading.
But concern is showing through, and it’s coming from the highest levels.
“You don’t punish me by not signing up for health care,” Obama told Hispanic audiences during a recent televised town hall. “You’re punishing yourself or your family.”
Hurdles in Texas
Tiffany Hogue, the health care campaign director for the Texas Organizing Project, works to inform uninsured residents — in many cases, Hispanics — about the law and its looming deadline.
Working across the state in some major urban markets, but not Austin, Texas Organizing Project workers have realized that Latinos tend to be some of the last people to find out about their eligibility for health care coverage and subsidies, Hogue said.
A major hurdle for uninsured Hispanics in Texas has been the decision by state leaders not to participate in anything having to do with the Affordable Care Act, including running the marketplace and not expanding Medicaid, she said.
“The climate in Texas is definitely hostile,” Hogue said. “The information is not trickling down.”
As a result, Texas is likely to fare worse than other states in the percentage of Hispanics getting covered, she said.
About 300,000 Texans signed up for health insurance plans under the new law through February, according to the most recent figures released by the federal government, but that leaves 2.8 million people in Texas who are eligible to enroll in marketplace plans and remain uninsured.
In Austin, Oné Musel-Gilley, a Hispanic education consultant and spokeswoman for the River City Youth Foundation, said she is seeing the same challenges facing Hispanics across the U.S. playing out in Central Texas.
The foundation, a neighborhood-based youth services organization, has been trying to overcome barriers — such as limited access to technology and low literacy rates — to inform people about the new health care law.
“We’re working hard to make as many informed as we can before March 31,” she said. “We see the clock ticking, and we know there are so many more to reach.”
The foundation is one of several groups in the Austin area working together to reach Hispanics, Musel-Gilley said.
Fear, mistrust, glitches
Experts cite other overlapping factors behind disappointing Latino sign-ups:
- A shortage of in-person helpers to guide consumers. “In our community, trust and confidence is so important — you want to make sure it’s OK before you share all this personal information,” Delgado said. There’s been a lack of “culturally sensitive” outreach to Latinos, added U.S. Rep. Lloyd Doggett, D-Austin.
- Fear that applying for health care will bring unwelcome scrutiny from immigration authorities. The health insurance exchanges are only for citizens and legal U.S. residents, but many Hispanic families have mixed immigration status. Some members might be native born, while others might be here illegally. Obama has tried to dispel concerns, saying information on applications will not be shared with immigration authorities.
- Technical difficulties that delayed the federal government’s Spanish-language enrollment site. CuidadoDeSalud.gov has also had to cope with clunky translations.
Delgado’s group is asking the administration to extend the March 31 deadline for Latinos who got tangled up in website problems. Officials say that’s not likely. However, they haven’t ruled out a little extra time for anyone who started an application but wasn’t able to finish by the deadline.
Dr. Esteban López, regional president of Blue Cross and Blue Shield of Texas, said his company “is all in” and is dedicated to reaching as many people as possible with information about the law. Realizing there would be challenges for Hispanics and other groups, Blue Cross and Blue Shield of Texas created the “Be Covered Texas,” a nonbranded campaign in English and Spanish, as a way to educate Texans.
The insurer, which is selling policies on the marketplace across the state, has also been reaching tens of thousands of people through education fairs and working with housing authorities and organizations such as the League of United Latin American Citizens, López said.
“I believe it is working,” he said.
But López is also a realist with a long view.
“This is really a marathon and not a sprint,” he said, adding that he expects higher enrollment among Hispanics in subsequent enrollment periods as people further understand the law and its requirements — and as the penalties increase.
CORRECTION: This story has been updated to say that Dr. Esteban López is the regional president of Blue Cross and Blue Shield of Texas.