90.9 WBUR - Boston's NPR news station
Top Stories:
PLEDGE NOW
Here and Now with Robin Young
Public radio's live
midday news program
With sponsorship from
Mathworks - Accelerating the pace of engineering and science
Accelerating the pace
of engineering and science
Wednesday, February 26, 2014

Why Are Latinos Lagging On Health Insurance Enrollment?

Vincent Dunbar (right) sits with his mother, Cicilia Reve, as he speaks with Josue Arevalo, an insurance agent with Sunshine Life and Health Advisors, as he shops for an insurance policy for his mother under the Affordable Care Act, Nov. 5, 2013 in Miami, Florida. (Joe Raedle/Getty Images)

Vincent Dunbar (right) sits with his mother, Cicilia Reve, as he speaks with Josue Arevalo, an insurance agent with Sunshine Life and Health Advisors, as he shops for an insurance policy for his mother under the Affordable Care Act, Nov. 5, 2013 in Miami, Florida. (Joe Raedle/Getty Images)

With only six weeks left before the March 31 deadline to enroll in health insurance under the Affordable Care Act, we check in on how signups are going — this time, in the Latino community.

In California, 1.7 million people have now enrolled through the state’s “Covered California” health exchange. But only 28 percent of those enrolled identify as Latino, even though Latinos make up 46 percent of the uninsured population.

Signup problems in California have included poor Spanish translation on the exchange website and a lack of Spanish-speaking employees at information hotlines. A Spanish language paper application wasn’t available until December.

U.S. Representative Loretta Sanchez, a Democrat from California, has been outspoken in her effort to enroll Latino residents.

Here & Now’s Jeremy Hobson checks in with her about California’s enrollment effort. He then turns to Univision producer Stephen Keppel for a sense of what is going on in the rest of the country.

Interview Highlights

Rep. Sanchez on the challenges of signing up Latinos for healthcare plans

“It’s just not a language issue, it’s also a cultural issue. You have to understand, for example, that Latinos are less likely to be on the Internet or have access to a computer, which means that even if they are, they go to the public library — you have a 30 minute time frame usually in which you can get onto the computer because there’s such a need, there’s a line for it. There’s no way that you could get on to Covered California and figure out what you needed for your family and be able to purchase and sign up for a plan within 30 minutes.”

“Remember we have mixed families in the Latino community, so somebody may not have the right paperwork or not be eligible for the ACA because they’ve been a legal resident less than five years, yet they might have children born here. Well, children need to be signed up. But children don’t go and sign themselves up. The person who either doesn’t have documents or who has been here less than five years, that’s in legal status, doesn’t want to jeopardize that for the ability to get citizenship by getting, quote, ‘a benefit’ from the United States. And so there’s a lot of education to be done.”

Stephen Keppel on Latino enrollment nationwide

“Actually, California is way out ahead of the rest of the country in this area. The congresswoman identified accurately a number of issues, with the outreach to Latinos and the enrollment of Latinos in California. But I think in other parts of the country, its probably even worse — especially those states that don’t have their own exchanges and haven’t expanded Medicaid… Texas and here in Florida, as well, the outreach has been even less, but we have huge populations of Latinos.”

Keppel on the reasons behind the low enrollment

“The government didn’t really think through how to launch or implement a law in two languages. I think, you know, this is the first time really that the government has had to think like that because this law impacts so many Latinos. About one in three Latinos don’t have insurance, so they have a lot to gain by this law. But I think it’s a lesson for governments going forward, if you’re going to implement something big, you’re going to have to do it now in English and in Spanish. Another factor is — especially recent immigrants, this idea of health insurance is different in some of their countries that they’re coming from in Latin America. It’s a very different system. So there is a lot of education and awareness that needs to be done.”

Guest

Transcript

JEREMY HOBSON, HOST:

It's HERE AND NOW, and there are now only 33 days to go until the open enrollment deadline to sign up for health insurance under the Affordable Care Act. That means if you're uninsured, you have 33 days to get insured, or you could be subject to a tax penalty.

Now we've all heard about the problems people have had signing up, but it turns out those problems are much worse for Latinos. In California, only 28 percent of eligible Latino residents have signed up under the state's exchange, even though Latinos make up 46 percent of the uninsured population there.

Congresswoman Loretta Sanchez is a Democrat from California. She's been out front pushing people to act on this issue, and she's with us now. Congresswoman, welcome.

REPRESENTATIVE LORETTA SANCHEZ: Thank you.

HOBSON: Well, what went wrong with getting Latinos signed up, and who's to blame for it?

SANCHEZ: Well, we identified the fact that almost half of Californians that did not have health insurance and were eligible to have would be Latinos. I identified that to Peter Lee, who of course is the executive director of Covered California, very early on. Unfortunately, that was kind of ignored. So now they're playing catch-up.

And that tends to be the case almost with everything with Latinos. People, you know, we try to tell them this is really the sweet spot, this is what we need to do, this is where we need to go, and people kind of don't really understand the demographics and the need there. But we...

HOBSON: Even in California they don't?

SANCHEZ: Even in California. It always amazes me how little attention is paid towards the Latino community in a lot of these broader outreach programs.

HOBSON: Now this is something that has been happening across the country to varying degrees, and we're going to hear more about that in a few minutes. But could the Obama administration have done more here? Obviously this is President Obama's signature piece of legislation. He has every interest in it succeeding. And if Latinos are such a big part of the success, should they have been doing more?

SANCHEZ: Well, I believe that we can all agree that the people who were implementing the Affordable Care Act from the federal side, given the fiasco in the beginning of the website, et cetera, really had their hands full and were somewhat overwhelmed, even though it was a three-year process. I mean, most of us are pretty angry about the rollout or the lack of a rollout.

And certainly even worse was the fact that if that - if they didn't do such a good job in English, imagine that they didn't do such a good job in Spanish. But it's just not a language issue, it's also a cultural issue. You have to understand, for example, that Latinos are less likely to be on the Internet or have access to a computer, which means that even if they are, they go to the public library.

You have a 30-minute time frame usually in which you can get onto the computer because there's such a need, there's a line for it. There's no way that you could get on to Covered California and figure out what you needed for your family and be able to purchase and sign up for a plan within 30 minutes.

HOBSON: Well, and we've heard about cultural issues having to do with signing up for something through the government because of their immigration status or maybe one of their relatives' immigration status.

SANCHEZ: Absolutely. Remember we have mixed families in the Latino community. So somebody may not have the right paperwork or not be eligible for the ACA because they've been a legal resident less than five years, yet they might have children born here.

Well, children need to be signed up. And so the whole - but children don't go and sign themselves up. The person who either doesn't have documents or who has been here less than five years, that's in legal status, doesn't want to jeopardize that for the ability to get citizenship by getting, quote, a benefit from the United States.

And so there - you know, there's a lot of education to be done in order to drive those people into the right place and get them to understand it's not about you, it's about your kids, and oh by the way, they must have a health care plan by the 31st of March.

HOBSON: Yeah, well, and so Peter Lee, who you mentioned, the head of Covered California, has promised $8.2 million to help sign up more Latinos. Is that going to work?

SANCHEZ: Well, you know, it's like anything else. You throw it at the last minute at the problem. It would've been much better if we could've had that money over the last six months to sign these people up, to get the information out, to saturate. Sometimes, you know, people don't get a message until they've heard it seven different ways. And to do it all at the very end is more in my opinion of like a scare tactic than it is to work through the community and understand what's happening and get people signed up. So we are working very hard to get this done.

HOBSON: Democratic Congresswoman Loretta Sanchez, joining us from Washington. Congresswoman, thanks so much.

SANCHEZ: Thank you.

HOBSON: Well, let's get the national picture on this now with Stephen Keppel. He's with Univision News in Doral, Florida. Stephen, welcome.

STEPHEN KEPPEL: Jeremy, great to be with you.

HOBSON: Well, so is this a California-specific issue, or is it happening across the rest of the country that Latinos are having a harder time, for whatever reason, signing up for health care?

KEPPEL: I think to be clear, we need to realize that actually, California is way out ahead of the rest of the country in this area. So the congresswoman identified accurately a number of issues with the outreach to Latinos and the enrollment of Latinos in California.

But I think in other parts of the country, it's probably even worse, especially those states that don't have their own exchanges and haven't expanded Medicaid.

HOBSON: We're talking about places like Texas.

KEPPEL: Yeah, Texas and here in Florida, as well. The outreach has been even less, but we have huge populations of Latinos. And if the state hasn't really promoted the law, and in many cases has actually kind of come out and fought against the law, there's just a lot of people that aren't getting the information.

HOBSON: Well, what are the problems exactly that are specific to the Latino community that everyone else is not facing as a burden to signing up for health care, in your view, in addition to what the congresswoman had to say?

KEPPEL: Sure, I think there are a few things. One, there's been issues with the rollout and the implementation. Everybody knows about the failures of the website. What they may not know is that the federal website wasn't translated into Spanish until maybe December or January. So they lost some valuable time there.

HOBSON: It launched in October.

KEPPEL: Yeah, the federal launched in October in English but not in Spanish. And I think as well, the government didn't really think through how to launch or implement a law in two languages. I mean, I think, you know, this is the first time really that the government has had to think like that because this law impacts so many Latinos.

You know, about one in three Latinos don't have insurance. So they have a lot to gain by this law. But I think, you know, it's a lesson for governments going forward, if you're going to implement something big, you know, you're going to have to do it now in English and in Spanish.

Another factor is especially recent immigrants, this idea of health insurance is different in some of their countries that they're coming from in Latin America. It's a very different system. So there is a lot of education and awareness that needs to be done. You know, that hasn't happened yet. And now there's like a big rush.

HOBSON: I'm imagining that yeah, at the deadline, you're not going to see every uninsured Latino-American signing up for health insurance. There are going to be a lot of people with tax penalties. How are they going to react to that? Who are they going to blame for the fact that they weren't able to do what they are required to do under the law?

KEPPEL: Yeah, that's going to be interesting to see. I do think we're going to see more people signing up before the deadline. But I think yeah, there's going to be, this first year, a lot of people that end up paying the fine. It remains to be seen who they're going to blame. But I mean, I think over the long run, people will, you know, will get the information they need and, you know, will figure out a way to sign up.

HOBSON: Stephen Keppel with Univision News, joining us from Doral, Florida. Stephen, thanks so much.

KEPPEL: It's been a pleasure, Jeremy.

HOBSON: Well, let us know if you have had any problems signing up for health care, whether you are Latino or not. Do you have questions still about the Affordable Care Act? You can go to our website, hereandnow.org. This is HERE AND NOW. Transcript provided by NPR, Copyright NPR.


Please follow our community rules when engaging in comment discussion on this site.
  • MarianTheLibrarian

    If you don’t stop pushing Spanish bilingualism, we’ll be forced to make English the official language. As an ex-Canadian, believe me, you don’t want to go down that road. Can’t even use an Italian word on a menu or the language police will get you.

  • nissa378

    if i can remember correctly, we are in America. That means the primary language is English. When my grandfather came here from Lebanon thru Ellis Island, Im sure they did not offer instructions and directions in 20 different languages. He in fact, wait for it…… LEARNED ENGLISH! imagine that. Moved to a foreign land at 12, and in order to be prosperous and survive he learned the language they speak. He did not cry or bemoan that the Government was not doing their job in providing information in Arabic, or just not work because he “did not speak english”. This is NOT a legit excuse anymore. Even the most third world countries they can understand english. Sorry, your excuse is pitiful. LEARN ENGLISH. there are free courses to do so. LEARN ENGLISH. The victim role is making you look bad

    • Denise Rehfuss

      I agree 100%.

  • Justin in Fairbanks, AK

    I was listening to the radio this morning like I usually do when I am headed to work. I hardly ever comment online, but I have to say something here. The first question Hobson asked was, “who is to blame for it?”; in reference to not enough Latinos signing up for health care. Here and Now has been broadcast nationally now for a while, and constant poor questioning from the people on this show is turning me away from NPR from 8-10. I am sure there have been a lot of calls for a return of Talk of the Nation, and I would be on board with that. However, it isn’t coming back. So I am just pleading with whoever arranges the interviews to ask more thoughtful questions. You were talking to a congressman. A combative question like that insults the intelligence of the interviewee and the listener. And frankly it saddens me that even NPR is using “least common denominator” tactics to get viewers. Clean it up Please.

    • Denise Rehfuss

      I thought it was a fair question. What made me angry was that it was trying to make it look like the government hasn’t done enough hand holding for the Latino population. Of course, the congresswoman will not place blame where it truly lies, which is with her constituents.

  • Caroline

    Many Latinos live in states where the Affordable Care Act is being squelched by GOP types ruling their states. Including translations for Information is not available, and scuttle-butt is, there’s no help for those who are confused about how to enroll. Come-on! I’ve got cans of soup in my cupboard with Spanish translation. My TV came with Latino, and French, and (what looks like) Chinese. It isn’t just Latinos who find forms difficult to fill out, but they are probably very worried that they’ll mess up and better to stick it out, avoid everything, and pay the penalty. I’ve got relatives, old and young who are WASPs [white and stubborn], and won’t sign up just because they’ve always taken care of themselves and want it that way.

  • Jo Buth

    I work with refugees from Burma who are here legally and have green cards. They lack sufficient skills in English and computer skills. There are about 70,000 refugees from Burma’s different ethnic groups and are having a huge problem signing up. There are refugees from other countries also who are having the same problems.

  • Babie

    I encountered many issues while trying to sign up for healthcare on Covered California website. It was nerve-wrecking when my username and passwords were not recognized by the website, and towards the end of the process I was not able to click “submit.” In the end I went straight to my current healthcare provider’s website, Blue Shield, to sign up for a plan. I received a letter yesterday saying that my application has been accepted and the plan will take effect on April 1. I also received a letter from Covered California saying that I have yet to provide more personal information. I supposed the information that I provided was not even saved into my profile.

  • Denise Rehfuss

    Asian and european immigrants, legal and illegal, learn English and have made significant educational and economic contributions to the American culture. They have made attempts to assimilate to their new home in the US, without losing their sense of self, and it shows. Latinos, on the other hand, don’t bother to respect our laws, language, or culture. They only take, take, take. Our government only contributes to the problem by trying to force us all to accept the invasion of illegal Latino immigrants and trying to force the US into being be bilangual. I am tired of the Latino population taking the victim stance on everything. I met a patient that has lived in the US illegally for 20 years and she still can’t speak a lick of English. There is no excuse. I have to pull my own weight and they should pull their own weight. It is no one’s fault but their own for not signing up for health insurance. Especially in Mexifornia.

  • TenThousandSawIataGlance

    I am very uncomfortable signing up for the affordable health plan. I support the program, and I think it is good for people, and society as a whole. I am healthy, but I would like to buy health insurance…but i have been hesitating because this program has become so politicized. There are some people and groups that are so strongly against the president and this program, that I fear these activists will go to any length to make this program have difficulties, and even fail. I think it is possible there were political reasons for the web site launch problems- how many of the site programmers were against health care reform i wonder.

    I fear that there are groups that may work hard in the future to discredit the program- perhaps by causing a massive security breach on the site, or something else that will harm those who sign up, in order to make the president look bad. I also feel it is very possible that as soon as the republicans gain control, they will repeal the act, and those who sign up will lose their insurance, or suffer some ramifications for having signed up.

    It is this uneasiness that those who sign up will be the victims of the political attacks against the plan that prevent me from signing up.

    • Cacimo

      Well Democrats have been using the IRS to go after Republicans – so things could turn around.

      • TenThousandSawIataGlance

        I’m not sure what you mean. I guess you are trying to divert attention away from my point by bringing up a topic that concerns you.

        Regardless, I do fear that there may be people working to undermine the health care program and cause a disaster in order to make the president look bad, and I’m worried that as a result, people trying to get insurance will be hurt. I really want to buy insurance, but I don’t know if I can risk it. I am crushed.

  • Cacimo

    LEARN ENGLISH.

Robin and Jeremy

Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

July 24 7 Comments

Veterans Say Suicide Is Their Top Concern

That's according to a survey released today by the group Iraq and Afghanistan Veterans of America (IAVA).

July 24 6 Comments

Modern-Day Amelia Earhart Circumnavigates The Globe

The famous pilot's namesake has became the youngest woman to fly a single-engine aircraft around the world.

July 23 Comment

DJ Sessions: Latin Alternative From Los Angeles To Venezuela

KCRW's Raul Campos introduces us to some groups he came across while hosting the 15th annual Latin Alternative Music Conference.

July 23 6 Comments

ISIS Forces Christians To Flee Iraq City Of Mosul

The militant group's threat -- convert, leave or die -- has forced most Christians in Mosul to leave.