Short Takes On News & Events

Survey: Latino Groups Worry About Money For ACA Enrollment

By Jenny Gold

July 18th, 2013, 2:49 PM

The Obama administration is counting on Latinos to help make the Affordable Care Act a success, but there may be troubles ahead: Hispanic health centers and community organizations say they don’t have the funding or resources to carry out the complicated sign up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.

(Photo by Callie Richmond/The Texas Tribune)

“Even with the federal grants given out, it does not nearly cover the populations we have to reach and the amount of work we have to do,” says Lori Baptista, director of policy at the Tiburcio Vasquez Health Center Inc. in Hayward, California. The center sees 14,000 patients and clients each year; 78 percent are Latino, and 70 percent do not speak English as a first language.

The ACA provides funding for “navigators” who are supposed to walk people through the enrollment process — which is likely to be akin to filling out a tax return in terms of complexity. Language barriers will add to that complexity for many eligible people.

Tiburcio Vasquez Health Center will be able to hire one full-time employee to work on enrolling patients in health coverage with the help of a federal grant specifically for federally qualified community health centers, but the center “could easily use 10 full-time navigators — that would be ideal,” Baptista says. Because California is running its own exchange, the center was able to get an additional grant from the state, but she says it still didn’t come close to filling the need.

“This is a complex process, and it’s significantly more time consuming to reach the Latino population,” many of whom have never had insurance before, says Baptista. “It requires a significant effort on the part of the navigator, the health center and the patients, especially those with limited English proficiency, to understand what opportunities are going to be available to them.”

The problem is even more severe for Hispanic community organizations that are not health centers and therefore do not have a dedicated source of federal funding, says Josephine Mercado, executive director of Hispanic Health Initiatives in Casselberry, Florida, a nonprofit that works on health education.

“We’re going to be getting the calls asking ‘Where should I go, and which plan should I buy?’ The challenge is doing it without getting paid. We’re not going to be able to do it on an all-volunteer basis,” says Mercado. “They’re already calling us.”

Hispanic Health Initiatives teamed up with two other local Hispanic organizations to apply for an enrollment grant from the federal government to hire 40 community health workers to help Latinos sign up. But Florida will only be getting $5.8 million in grants to enroll the state’s 3.5 million uninsured residents, which Stan Dorn, senior fellow at the nonpartisan Urban Institute, calls “a drop in the bucket.”

The organizations have not yet learned whether they will be awarded the grant.

Tiburcio Vasquez Health Center and Hispanic Health Initiatives were both part of a survey of 135 Hispanic health clinics and community organizations in 23 states, released Thursday by the National Council of La Raza.

The survey asked respondents to describe their ACA outreach plans and identify challenges and barriers to enrollment.  Those obstacles included lack of knowledge about coverage options and eligibility among patients and a lack of information from the state about plans, rules and regulations. A shortage of bilingual, bicultural staff trained in the enrollment process and insufficient funding for outreach efforts were also listed as important barriers.

“We have a lot of catching up to do,” says Manuela McDonough, a program manager at NCLR. “Community health centers and Hispanic community organizations are underfunded and understaffed and they can’t dedicate the time to do the necessary outreach to the most vulnerable populations.”

Without additional funding and culturally appropriate information, outreach efforts are unlikely to meet the needs of Hispanics, McDonough says, particularly because the While House’s “strategies and tactics for reaching Latinos are off.”

“They’re doing an online campaign, and a lot of the Latinos we serve don’t have access to online services,” she explains. The translation of the Obamacare website,, is “not culturally competent,” she adds, and some of the videos are still in English.

And that makes the outreach efforts by local Hispanic organizations even more important. “The state and federal systems are likely to be complex, and a lot of them rely on online enrollment systems or call centers that may not have counselors who speak Spanish well,” says Jim Maxwell, director of research at JSI Research & Training Institute Inc. in Boston, which conducted the NCLR survey.

Even after health reform in Massachusetts, he adds, Hispanics were still the most likely to be uninsured. “And the success that did occur in Massachusetts was largely to do the role of Hispanic community based organizations and health centers.”

For its part, the Obama administration says it recognizes the important and challenging job of reaching out to Latinos.

“As one of the most disproportionately uninsured populations, Latinos are a key group to reach ahead of open enrollment in October,” says Joanne Peters, a spokeswoman for the federal Department of Health and Human Services. “As we move forward, we will continue reaching out to diverse communities, including those Americans who speak Spanish or other languages to ensure they can take advantage of new and better health insurance choices.”

9 Responses to “Survey: Latino Groups Worry About Money For ACA Enrollment”

  1. wilson says:

    With Republicans in the U.S. House of Representatives trying their best to defund Obamacare, no wonder Latinos are worried! Republicans keep saying that they love the Latino community. Yeah! Right! When pigs fly! Republicans love the Latino community like they love President Obama….NOT! The Latino community needs to understand that they have no friends in the Republican party. As a Latino, with friends like Republicans, who needs enemies?

  2. Priscilla says:

    I really like what you guys are up too. This kind of
    clever work and coverage! Keep up the excellent works guys
    I’ve added you guys to blogroll.

  3. It was my understanding that unlicensed navigators were not allowed to answer the question, “Which should I buy.” Apparently, there are already plans to break the law.

  4. Sheldon says:

    “Apparently, there are already plans to break the law.” This from a guy that has a section on his website titled “How to Delay Obamacare.”

    Nothing in this article even remotely indicates that navigators will direct consumers to specific policies. So, Tim, stop with the paranoia and misinformation. As an agent, you should embrace the ACA. Millions of new private insurance customers, many of whom will have their purchases subsidized by the government, is a boon for insurers and agents. There won’t be enough navigators to reach even a fraction of the population in need (which is a point made in the article). So, stop worrying. There’s going to be plenty of customers and plenty of business to go around.

  5. Venus says:

    Navigators are individuals and entities that will provide unbiased information to consumers about health insurance, the new health insurance marketplace, qualified health plans and public programs including Medicaid and the Children’s Health Insurance Program. Navigators will understand and be able to explain everything from the technology behind the exchange to the vast resources available to help consumers make informed choices on their health insurance options. A valuable resource, navigators will help Texans collect as much important information as possible so they can make the best possible decisions when enrolling in health insurance exchanges starting this fall. With Texas’s 38% Latino population, I concur with some of the concerns stated in this article. A dedicated program should be in place to insure that Navigators are culturally and linguistically proficient and representative of the communities they will be serving, especially in the area of education.

  6. Sheldon, if you bother to take time to understand the facts, you will know that there is nothing illegal to delaying Obamacare. That page that offends you so much that you claim provides misinformation encourages people to use the exchanges if they need maternity or substance abuse coverage. It just advises those people who plan to disregard the law and pay a “shared responsibility payment” on an alternative that was approved by the Department of Health and Human Services. It does not encourage anyone to do anything illegal. It just gives people options.
    Unfortunately, this article points out what the insurance industry feared. Unlicensed people are already planning to violate state laws and practice insurance without a license. My comments are not based in politics. They are based on the law and rules that were published by the Department of Health and Human Services.

  7. Wendy says:


    I found those HHS rules that Tim is talking about. Check it out…

  8. wilson says:

    The best thing to happen for the Latino community in recent history is the Affordable Care Act. In spite of constant Republican efforts in Congress to make affordable healthcare unavailable for them, Latinos and other minorities in some states will finally get a chance to see a doctor on a regular basis. Yet, states like Pennsylvania and Texas and Alabama are still fighting healthcare reform. Governors like Tom Corbett and Rick Perry will not help more uninsured poor people get access to healthcare by expanding Medicaid. Smart governors, those without right-wing political and ideological agendas, are moving forward and expanding Medicaid because they know that doing so will bring much needed revenues into their states and help create good jobs and boost their economy. Not only will Medicaid expansion boost the economy in states that participate, it will create a much more healthy population. With less uninsured sick people going to hospital emergency rooms for uncompensated care, we will see less hospitals going bankrupt. Dumb Neanderthals like Perry and Corbett have not figured that out yet. I hope voters remember this in 2014.

  9. Lang says:

    This kind of topic should be more spread. It’s great you guys had a coverage of it, people need to be more aware. Great job.