On a recent afternoon, Teresa Ying spoke to a dozen people gathered in a meeting room at the Chinatown branch of the Los Angeles Public Library. They were Chinese-language speakers and middle-aged or older.
Speaking in Cantonese, she explained the requirements and options under the Affordable Care Act to a group of people for whom much of this information was new. Then she told them they could begin signing up, and that help would be available at the library: not on this day, but in the weeks to come.
In the terminology of Covered California, the state-run health insurance marketplace, Ying is a certified enrollment counselor, someone trained and authorized by the agency to help people sign up for new plans.
These counselors are especially important in communities like Chinatown – immigrant and poorer neighborhoods where people often need step-by-step help through the application, which is currently available only in English and Spanish.
"They’re monolingual in Chinese," said Ying, who works for the nonprofit Chinatown Service Center. "A lot of them are older and not computer savvy. So there’s no way that they can even begin to access the Internet."
Earlier this year, Covered California had plans to train 20,000 enrollment counselors by Dec. 31. The agency revised the goal downward to 16,000 over the summer, and in the fall it revised it again, to 5,000. As of Dec. 7, it had certified just 2,300, with another 3,700 in some stage of the approval process.
Ying is one of those who have been fully certified. But Luong Chau, who was also on hand at the Chinatown presentation, is among those still waiting. She’d finished her certification and was just waiting for her badge to arrive in the mail.
"Right now, I feel like I’m kind of in limbo," she said, "where I can answer questions but not necessarily give consumers what they need, which is to actually enroll in health care."
Less than two weeks before Covered California’s Dec. 23 deadline to sign up for coverage that kicks in Jan. 1, officials at several clinics and nonprofits that serve some of Los Angeles’ neediest communities reported having staff in similar situations.
They say the process of getting them certified has taken longer than they’d hoped, meaning that for now all they can do is tell their clients to wait or refer them to organizations whose staffs have been fully certified.
Jackie Provost is director of programs at the UMMA Community Clinic in South Los Angeles. She’s trying to get nine of her staff certified as enrollment counselors. They’ve all been going through the steps: three days of training, background checks, reference letters. But only three have been fully certified, and she’s not sure why.
"The process has been extremely difficult. It’s been long, and it’s been a little confusing," Provost said.
Provost noted that her clinic hosted an enrollment fair last weekend, and she would have liked to have more staff ready to sign people up.
"It has definitely hurt the field in terms of being able to really maximize getting people access," she said.
Covered California Executive Director Peter Lee has acknowledged that the process for certifying enrollment counselors has taken longer than originally expected. He has said that’s because Covered California has increased the level of scrutiny it gives to each applicant’s background.
But despite being far short of the agency’s earlier goal to certify 16,000 counselors, he doesn’t think enrollment has been affected.
"I am satisfied that we’ve got enough to help every Californian who wants to enroll now - and I want more," he said.
He said people can also sign up online, at a county office, or over the phone. Covered California has also certified several thousand independent insurance agents to help.
But nonprofit agencies say the shoe-leather work done by enrollment counselors is especially important, because they are physically going into communities to educate, encourage, and help sign up people who might not otherwise do so.
Teresa Ying, the counselor who spoke to the group at the Chinatown library, said she will be at the library to help people sign up every week until Covered California’s March 31 enrollment deadline.
Luong Chau, who was waiting on her badge, said she hoped to be ready to sign people up by next week, and that she expected more counselors on hand as soon as Covered California works through its backlog.