California’s push to sign people up for health insurance under the Affordable Care Act is focused in part on non-English speakers, particularly those who speak primarily Spanish. The state estimates that hundreds of thousands of Spanish speakers are eligible for subsidies to buy private insurance through Covered California, the state-run marketplace. But in Covered California’s first month, fewer than one thousand Spanish speakers signed up.
Many Spanish speakers are ineligible for insurance under the federal law because they’re in the country illegally. Many more are on Medi-Cal, or will qualify for expanded Medi-Cal under the federal law. Still, the state estimates that more than 650,000 Spanish speakers will qualify for subsidies to buy a policy.
Thirty-three year old Jorge Ramirez is an example of the type of Spanish speaker Covered California covets. On a recent afternoon, he visited the South Central Family Health Center, a community clinic in South L.A., to learn more about Obamacare.
Ramirez told Olivia Mendez, a health promoter who helps people navigate the federal law, that he works at a taco shop, but his boss does not provide health insurance. Ramirez makes too much to qualify for Medi-Cal, and he never bought himself an individual plan because he said he rarely gets sick.
Mendez explains that Ramirez shouldn't wait until he's sick to buy insurance. Still, Ramirez is unsure about what to do.
He says he wants to see whether it's cheaper to pay the penalty for not buying insurance, or purchase a policy "I'm not going to use."
Mendez says that attitude is common among young, single Latino men like Ramirez.
Genevieve Filmardirossian, the clinic’s associate director, sees the challenge partly in terms of education.
"According to the research that we have done, there are pockets of individuals who may be able to qualify, and they’re just not informed," she said.
Depending on his income, Ramirez might qualify for subsidies that would cut the cost of any insurance policy he might buy.
Using state and federal grants, Filmardirossian hired seven temporary employees whose main job will be to identify people such as Jorge Ramirez and help them enroll in Covered California. But there have been snags.
It’s taken the seven new employees longer than expected to get the state certification they need to start enrolling people. And as of this week, if you visit Covered California’s Spanish enrollment page, you can still only get plan information in English.
Covered California spokesman Santiago Lucero says the agency is hard at work on the problem.
"We just had an upgrade where they did translate properly some of the language in the website," he said. "That is an ongoing process."
In the meantime, people can call to apply, or use a paper application -- except it’s still not available in Spanish. Covered California expects to have the Spanish-language paper application ready by the middle of the month.
Even with all of the problems, Lucero says Covered California expected that Latinos would be slower to buy insurance than the general population, in part because many Latinos prefer to enroll at clinics, with the help of trained staff.
He said that so far Covered California has certified 2,000 enrollment counselors, "and 60 percent of those are Latinos, bilingual Spanish speakers. So that is good news, but this is not enough, we’re going to keep doing more."
Some advocates have called for enrollment counselor training in Spanish, but Lucero says there are no plans to do that.
For now, he says, the state’s main goal is to finalize the certification of thousands of counselors who speak both English and Spanish.