Jose Gaspar

Sunday, Dec 22 2013 08:00 PM

JOSE GASPAR: Anemic Hispanic enrollment a big problem for Obamacare

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    By Henry A. Barrios/ The Californian

    Californian contributing columnist Jose Gaspar.

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By Jose Gaspar

Ever since he started working as an adult, the 25-year-old father had never had a job that provided health benefits. All trips to the doctor as well as prescriptions for him and his wife were paid by them. In fact, Hermes Castro of Lamont is currently paying off $4,000 in medical bills as a result of having to be taken by ambulance to Kern Medical Center when he had a severe allergic reaction.

For the first time in his life, however, Castro will finally have medical coverage.

"I didn't know poor people can have health insurance," said Castro, who makes between $21,000 and $22,000 a year and works as a butcher.

Last Saturday, Castro was among the 15 Lamont residents who attended a workshop held by local Assemblyman Rudy Salas on the Affordable Care Act, aka Obamacare, the new federal health-care law.

Certified enrollment counselors from Clinica Sierra Vista were on hand to help people enroll in Covered California, the state's insurance exchange. Castro was enrolled and found out he, his wife and 2-yar-old daughter qualified for Medi-Cal, the state's program for the poor.

"This will help a lot. My family will be able to see a doctor and I'll have more money in my pocket for other needs," said the young father. He smiled when he mentioned the part of saving money.

But getting California's Spanish-speaking population to enroll in Covered California so far has been less than stellar. Some describe enrollment among Hispanics in medical terms as anemic, faint, weak and pale. The numbers tell the story.

In figures released on Dec. 12 from Covered California, 159,000 people statewide had enrolled in private health plans since Oct. 1. Another 179,000 were likely to qualify for Medi-Cal. But enrollment among those who are primarily Spanish-speaking is seriously lagging.

According to statistics from Covered California, slightly less than 5 percent of enrollees were primarily Spanish-speakers. Now consider that Hispanics represent about half of California's 7 million uninsured residents and you've got a serious health issue. While just 5 percent of those enrolled primarily speak Spanish, this group makes up 29 percent of the state's total population.

Que pasa? Something here has been lost in translation.

"We are lagging in enrollment for Spanish-speakers," said Lizelda Lopez, spokesperson for Covered California for the Central Valley. "We are not hitting the mark."

Not hitting the mark by a long shot so far. The numbers are also weak in Kern County, where a total of 1,146 people had enrolled as of Nov. 30. Out of that number, 112 identify themselves as Spanish-speakers, said Larry Hicks with Covered California.

Given that the state allotted $86 million to promote enrollment, the figures so far have prompted some state and local politicos to question and demand Covered California do a better job of reaching all communities, especially Hispanics.

"We are not going to sit back and wait any longer. Covered California's strategy for Latino enrollment has not proven itself to be effective to this point," said state Sen. Norma Torres of Los Angeles in a press release. "We are going to do everything in our power to change that."

For his part, Assemblyman Salas joined the California Latino Legislative Caucus in firing off a letter to the Board of Directors at Covered California. The letter said that while caucus members appreciate the amount of work Covered California has done, it needed to do more to reach a key demographic group and asked Covered California to publicly share its plans to improve outreach and enrollment efforts.

Salas has also been holding workshops in his district explaining the health care law and people can enroll on the spot with help from Clinica Sierra Vista.

There are myriad reasons for the low enrollment numbers. One reason cited was the delay in certifying enough Covered California enrollment counselors. These people are the boots on the ground who meet face-to-face with the public and assist them with the enrollment process. But in some cases, the certification process from Covered California was lethargic.

"We got off to a slow start because it took six weeks to get counselors certified," said Edgar Aguilar, program manager with Dignity Health in Bakersfield, which is another entity that helps the public enroll in Covered California.

In fact, the agency has continuously decreased the number of counselors. Where once Covered California had plans to train 20,000 enrollment counselors by Dec. 31, that figure was slashed to 16,000. Then that number was cut to 5,000.

As of Dec. 7, just 2,300 enrollment counselors statewide had been certified.

"We are guilty of being overly ambitious in getting that many, but we do have more than enough adequate number of enrollment counselors," said Hicks.

Another reason could be the fact that undocumented immigrants are not eligible to buy coverage on the health exchange nor qualify for Medi-Cal. This includes hundreds of thousands of young people who were granted deferred action status under the Department of Homeland Security's deferred action for childhood arrivals, known as DACA. To further confuse the situation, other immigrants may qualify depending on their particular immigration status.

Others have their own take on why enrollment among Spanish-speakers is low thus far.

"Part of it is cultural," said Steve Schilling, CEO at Clinica Sierra Vista. "This is a population that for the most part has never had the experience of getting health insurance."

That makes sense. In Kern County, agricultural jobs are dominated by Hispanics, but health insurance through their employer is a rarity afforded to most. And purchasing a private plan can be too costly.

Then there's the issue of mixed immigration status within families. Some family members are documented, others are not, others may be pending. The fear of turning over this information to the state makes some people pause out of concern it could land in the wrong government hands.

For the record, the folks at Covered California assure me that none of the information collected is shared with ICE, Immigration and Customs Enforcement. But how about the NSA? That's another story.

Here's a key reason why federal officials should be worried about the low enrollment thus far among the Spanish-speaking population in California. It could be a red flag that enrollment among Hispanics nationwide could also be lagging.

While the 5 percent figure does not reflect the number of Hispanics who registered in English, it is still lower than enrollment of others who registered in Asian and Pacific Islander languages. Yet that group makes up far less of the state population than Spanish-speakers.

Hispanics are strong supporters of Obamacare, as reflected in a November USC Dornsife/Los Angeles Times poll that showed a nearly two-thirds approval rating, while 49 percent of non-Hispanic whites oppose it. Somehow, Covered California is going to have to figure out a way to turn that support on paper into action.

Jose Gaspar is a reporter for "KBAK/KBFX Eyewitness News" and a contributing columnist for The Californian. These are Gaspar's opinions, not necessarily The Californian's. Email him at elcompa29@gmail.com.

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