Obamacare and Latinos: why a crucial constituency is wary of signing up

Website glitches aside, President Obama's new health-care law also is causing consternation among many Latinos over the possibility that signing up for the Affordable Care Act could get family members deported.

"It's a very real barrier," say Daniel Zingale, vice president of the California Endowment, a Los Angeles nonprofit that promotes the law among Latinos.

"Families are worried about being deported and divided by having any official interaction with the government," he says.

The fear that's keeping many of the 10.2 million Latinos eligible for the Affordable Care Act, often called Obamacare, from buying the mandated insurance is common among families of mixed legal status, health-care advocates say.
 
"Our community is about family, so protecting the family comes first," says Jane Delgado, executive director of the National Alliance for Hispanic Health in Washington.

"This is very personal information that they're being asked to share," she adds.

About 9 million people live in families that include members who are in the US legally as well as some who are here illegally, according to the Pew Research Center. Under the new law, only people in the country legally qualify for help with health-care insurance.

Despite a public statement released by Immigration and Customs Enforcement (ICE) that health-care information would remain confidential, many Latinos remain skeptical that an agency that has deported record numbers of people in the past few years will keep its promise.

The Obama administration deported 368,644 people last year. While that level marks a 10 percent drop from 2012, the decrease was the first reported since the president took office in 2009.

"There's a great deal of skepticism and a lack of trust, and it's understandable given the large number of families who have been divided and deported," says Mr. Zingale of the California Endowment. 

To succeed, the law must attract many more Latinos, who as a group are younger than the overall US population, to enroll in private health-care plans. The federal government offers subsidies to qualified enrollees.

Through December, 2.2 million people enrolled in health-care insurance through online exchanges, or marketplaces, launched in October, according to the US Department of Health and Human Services. The number includes no breakdown by ethnicity.

In California, which has the nation's largest number of Latinos, Mr. Zingale says an all-out effort is underway to get Latinos to sign up for health-care insurance. This includes a Spanish-language billboard campaign and media initiatives similar to those publicizing the law in other states.

"Latinos comprise roughly half of all Californians who are eligible for Obamacare, so if we fail among Latinos we will fail in implementing the new law," he adds.

Thirty-eight percent of California's 38 million residents are Latino, and many of them prefer to speak Spanish.

"There are a lot of challenges in enrolling large numbers of people in California, especially when there are cultural and language barriers," Zingale adds."We have a poor track record here of enrollment in public programs … so we're trying to break our losing streak with Obamacare, and there are signs that we're moving in the right direction."

In states that chose to let the federal government run the health-care exchange, such as Arizona, health-care advocates also are reaching out to Latinos who may be reluctant to sign up for health insurance, some for the first time.

Thirty-five percent of all Latino adults in the state are uninsured, compared with 10 percent of non-Hispanic whites, says Kim VanPelt, director of state health policy and advocacy with Cover Arizona, a coalition of organizations providing health-care resources and assurances.

"Clearly, it's incredibly important to be effective in terms of reaching out to the Latino population," she says.

In Minnesota, health-care advocates have enlisted help from established community leaders and businesses in Latino areas to get the word out about the law, as well as to emphasize that enrolling won't get family members expelled from the country.

"There's still a lot of concern in mixed families," says Carla Kohler, community health worker services manager at CLUES, a health-care provider in the Twin Cities.

"There are a large number of children who are uninsured within the state of Minnesota, and it could partly be because of that fear," she adds.

To ease people's angst, health-care advocates are now telling families that ICE has drawn a line between enrollment and immigration enforcement.

But health-care activists say that, in addition, public assurances from Obama would go a long way toward quelling anxiety about deportation.

"I don't think it's asking too much for the president himself to offer legal Americans eligible for Obamacare the reassurance that they can enroll in this program without having their loved ones deported," says Zingale.