Visits to healthcare.gov are surging in these last days before the Affordable Care Act enrollment deadline. But government officials are worried that they aren’t getting enough of the right people to sign up. Latinos in particular are sorely needed to balance insurance pools. They tend to be younger and healthier than the general population. But states with the largest concentration of Latinos - like California - have been struggling to win them over.
“The news gives a lot of information, [but] it confuses people. They don’t know what is the truth,” says Larissa Bobadilla, a health outreach worker in Los Angeles.
Many Latinos are afraid that if they sign up for health insurance, their undocumented family members will get discovered, and deported. Others aren't convinced it's worth the money.
People like Bobadilla are out trying convince them that it's okay.
“They trust me,” she says.
They trust her because she's been on the streets of LA for 16 years working as a promotora, a health educator. Now the kids of people she helped years ago are coming to her to find out what's really going on with Obamacare.
This is exactly what California officials want - trusted members of the Latino community explaining health plans to potential customers in Spanish.
The trouble is, the state is short thousands of these insurance counselors.
Political wrangling at the federal level is partly to blame. That delayed the roll out of programs for training counselors. And that left no time to approve a Spanish training curriculum or a Spanish certification test. Bobadilla was lucky. She had enough English to get by.
“I don't know, I feeling so nervous, feeling so-- frustration,” she says
But other promotoras in her community didn't pass the test, and they can't help anybody until they do.
This shortage of people power isn't just limited to the streets.
The state insurance exchange, Covered California, underestimated how many counselors it would need to staff its call centers. Many people who asked to speak to someone in Spanish got transferred to English-speaking agents. When there are too many calls, the system hangs up.
Similar problems have plagued the website.
“I visited it, with my brother’s help, and we tried to enroll. But it didn’t work,” says Maria Aurelia, a teacher from San Pablo, east of San Francisco. “I would much rather sign up – face to face. There’s more communication.”
These disasters in customer service are one of the main reasons Latino enrollment has been so far below expectations.
So far, just 8 percent of people who enrolled in a health plan through California’s exchange by the end of last year speak Spanish as their first language. The state had been aiming for something closer to the representation of Spanish speakers in the state population — nearly 30 percent. (The federal government has not released demographic data on enrollees.)
California officials are worried about this shortfall because the economics of the new health care system depend on Latinos. Because Latinos tend to be younger and healthier than the population as whole, their premiums subsidize care for older, sicker people, which helps keep costs down for everyone else. That’s why officials have been been scrambling in recent weeks to hire more Spanish speaking customer service agents and make improvements to the system.
But even that will do nothing to overcome another serious obstacle: Cost. Many plans run two, three hundred dollars a month. Sometimes more.
“Good price? Hundred dollars a month,” says construction worker Jose Rodriguez.
Maria Aurelia also says she would prefer a monthly payment of one hundred dollars for her family.
Research shows that only a quarter of Latinos are willing to pay more than $100 a month for health insurance, according to Hispanic market research group Santiago Solutions. Carlos Santiago, the group’s founder, says many Latino families have never had insurance, making it difficult to see the value in it at such a high cost.
“You kind of go wait a minute, am I really going to use this right away?” he says. “How much do I need that security right now, this year when I have all these other realities in my life.”
The deadline to sign up is March 31 - though people who encounter technical problems with the website can get an extra two weeks to finish their application.