California’s Obamacare Program Is Succeeding—Just Not Among Latinos

The Golden State boasts massive enrollment numbers, but not among its Spanish-speaking residents.

SACRAMENTO, CA - NOVEMBER 13: Covered California Executive Director Peter Lee speaks during a press conference regarding the number of new healthcare enrollees through CoveredCA.com, the health insurance exchange for the state of California, on November 13, 2013 in Sacramento, California. A total of 30,830 Californians enrolled through the exchange in the month of October, with a total of 59,830 people enrolled through November 12. 
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Sophie Novack
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Sophie Novack
Feb. 20, 2014, midnight

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.

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