California has been a star example of Obamacare implementation done right, except when it comes to enrolling its largest uninsured population: Latinos.
With six weeks remaining in the open enrollment period, Covered California—the state-based insurance exchange—has already exceeded its projected enrollment goal, with 828,638 signed up for coverage as of Feb. 14. Between the exchange and Medicaid, more than 1.6 million Californians enrolled in coverage from Oct. 1 to Jan. 31.
But for all its success, California's outreach has faltered among Latinos.
A full 46 percent—or 1.2 million—of the 2.6 million Californians who are estimated to be eligible for federal subsidies on the exchange are Latino. However, of the subsidy-eligible enrollees thus far who have indicated their race, Latinos make up only 22.5 percent.
"From day one focusing on Latino enrollment has been our No. 1 priority," said Covered California Executive Director Peter Lee on Wednesday. "Have we executed it perfectly? No. [But] we're getting better as we go, and we're seeing those results."
Hoping to catch up in the final weeks of open enrollment, the state exchange is launching an eleventh-hour messaging surge aimed at Latino residents.
A key element of the state's strategy moving forward will be in-person enrollment. Unlike the federal marketplace, Covered California's Spanish language website has been up and running since the start of open enrollment on Oct. 1, but other barriers have stymied sign-ups.
The state has boosted in-person assistance, adding more bilingual enrollment counselors and agents. Covered California has created partnerships with Latino supermarkets in Southern California to host enrollment events. It has also engaged elected officials, nonprofit organizations, and health care providers. More bilingual staff are being added to call centers and outreach programs.
Covered California is further increasing its marketing efforts and will spend $8.2 million through March on Spanish language media—an increase of 73 percent from the first three months.
A new ad campaign—Tengo un Plan de Salud, or "I Have a Health Plan," will highlight Latino Covered California enrollees who will address the importance of signing up for coverage.
The initiative will target seven regions that have high populations of subsidy-eligible Latinos: Los Angeles (the San Gabriel Valley, the San Fernando Valley, and South Los Angeles); the Inland Empire (San Bernardino and Riverside counties); and the Central Valley and the San Joaquin Valley (Stockton/Modesto and Fresno/Bakersfield).
Latino enrollment will go a long way toward determining the Affordable Care Act's success.
Overall, 25 percent of uninsured individuals in the U.S. who are eligible for coverage under the ACA are Latino. HHS estimates that 80 percent of these eligible uninsured Latinos could qualify for financial assistance under the law—either through federal subsidies on the exchanges or through Medicaid.
California has the largest population of eligible uninsured Latinos of any state—the 2.8 million in the state make up 28 percent of all eligible uninsured Latinos in the U.S.
Early signs suggest California is poised for a jump in Latino enrollment. Over 45,000 Latinos signed up for coverage in January, and Latino enrollment climbed to 28 percent, up from only 18 percent of cumulative enrollees between October and December. Enrollment of individuals who identified as Spanish-speaking jumped to 11.5 percent in January, from 5 percent in previous months.