Deportation Anxiety Is Making Latinos Obamacare Shy

Latinos are an essential component of the health insurance marketplace. But how do mixed-immigration status families know information they provide to the exchanges won’t be used against them?

National Journal
Lucia Graves
Dec. 27, 2013, 3:22 a.m.

En­roll­ment num­bers aren’t in yet, but the Obama ad­min­is­tra­tion already knows it has few­er Lati­nos signed up than it would like. One of the reas­ons they’re not en­rolling? People in mixed-im­mig­ra­tion status fam­il­ies worry per­son­al in­form­a­tion sub­mit­ted un­der the Af­ford­able Care Act could be used to de­port someone in their fam­ily.

“That’s a big fear and something that the cam­paign is try­ing to ad­dress,” said Hilda Mar­tinez, a cam­paign man­ager for Cali­for­nia En­dow­ment’s “Get Covered” cam­paign, which has spent tens of mil­lions of dol­lars on Span­ish-lan­guage me­dia out­reach. Un­will­ing to take a chance with their fam­ily be­ing torn apart, some im­mig­rants are tak­ing a chance with their health or their chil­dren’s health.

The is­sue is es­pe­cially crit­ic­al in Cali­for­nia, which has a big Latino pop­u­la­tion and has em­ployed one of the most vig­or­ous pub­lic-out­reach cam­paigns in the coun­try.

Au­thor­it­ies have de­por­ted a re­cord num­ber of im­mig­rants in re­cent years — more than 1.9 mil­lion since Pres­id­ent Obama took of­fice. With im­mig­ra­tion re­form stalled, it looks like more of the same will oc­cur in the new year.

U.S. Im­mig­ra­tion and Cus­toms En­force­ment has is­sued a let­ter as­sur­ing people that in­form­a­tion sub­mit­ted as part of ap­ply­ing for health in­sur­ance un­der the Af­ford­able Care Act will not be used for im­mig­ra­tion en­force­ment.

But Daniel Zin­gale, seni­or vice pres­id­ent with the Cali­for­nia En­dow­ment, says this as­sur­ance isn’t enough. “I think something from the pres­id­ent him­self would be help­ful,” he told Vic­tor­ia Col­li­v­er of the San Fran­cisco Chron­icle. Mar­tinez ad­ded it would be es­pe­cially use­ful to have something in Span­ish.

Bey­ond de­port­a­tion fears, Lati­nos who’ve avoided the health care sys­tem in the past lack ex­per­i­ence with the com­plex in­sur­ance land­scape. An­oth­er dif­fi­culty is provid­ing enough en­roll­ment coun­selors to as­sist Span­ish-speak­ing res­id­ents, who typ­ic­ally prefer face-to-face in­ter­ac­tions over the an­onym­ity of a web­site.

For those who want cov­er­age Jan. 1, the dead­line to sign up was Monday. The over­all en­roll­ment peri­od will con­tin­ue through March 31. These prob­lems of Latino en­roll­ment, however, will be dif­fi­cult to re­solve in just a few months.

The White House cer­tainly has mo­tiv­a­tion to pub­li­cize and em­phas­ize these as­sur­ances to the Latino pop­u­la­tion, whose en­roll­ment is con­sidered key to the suc­cess of the Af­ford­able Care Act’s rol­lout. Young­er and health­i­er than the av­er­age un­in­sured Amer­ic­an, Lati­nos would help cre­ate a bal­anced and af­ford­able health in­sur­ance pool.

And yet, giv­en ICE’s policy of pro­sec­utori­al dis­cre­tion, you can’t blame these fam­il­ies for wor­ry­ing. More than 368,000 people were de­por­ted this fisc­al year, and that’s ac­tu­ally a de­crease from the 409,000 de­por­ted dur­ing fisc­al 2012. In 2011, about 397,000 were de­por­ted.

“These fam­il­ies are just very fear­ful wheth­er it’s true or not,” said Mar­tinez. “We don’t have any reas­on to doubt the ad­min­is­tra­tion,” she ad­ded in ref­er­ence to ICE’s re­as­sur­ing mes­sage this fall, “but there’s this fear in the com­munity that isn’t just go­ing to go away with a let­ter.”

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