Sacramentans flock to sign up for the Affordable Care Act, but Latinos are slow to enroll

Twenty-seven-thousand people in the Sacramento area selected health-insurance plans through Covered California in the first three months of the marketplace’s opening, according to numbers released last week.

This total, says the Department of Health Care Services, equals about 95 percent of the region’s people that officials have guessed will enroll during the application period from October 2013 through March.

Although Latino participation remains disproportionately low, the state’s new health exchange is leading the nation in applications for health insurance under the guidelines of the Affordable Care Act.

In fact, enrollment rates skyrocketed in December, and the program’s launch has rebounded into what analysts are calling a success.

“No one realized how strong the pent-up desire for this was,” said Suzie Shupe, the executive director of California Coverage & Health Initiatives in Sacramento.

Compared to the 15 other states and the District of Columbia that similarly launched their own health-care exchanges, California has seen some of the greatest public interest in the program.

“California is doing really well, especially if you’re grading on a curve,” said Anthony Wright, the executive director of Health Access California, a group in Sacramento that lobbied for the Affordable Care Act and has supported the rollout of Covered California. Though home to just one-eighth of the population of the United States, California has accounted for more than a quarter of health-care sign-ups under the Affordable Care Act, which took full effect on January 1.

By late mid-January, 625,000 Californians had selected a health-care plan, while another 1.2 million were assessed and directed to Medi-Cal, the state’s assisted health-care program for the poor. In total, about 1.5 million Californians are now receiving assistance for health coverage that was not available previously.

The exchange will not close for 2014 until the end of March, and Wright expects a spike in applications in the coming weeks.

“At the end of the day, this is deadline driven,” he said. “It’s human nature—lots of people don’t sign up until the last minute.”

But as the deadline for enrollment approaches, many analysts are questioning why so few Latinos have signed up.

The ethnic group reportedly represents more than half of the state’s uninsured population. As of the year’s end, however, only 19 percent of Covered California’s applicants were Latino. A language barrier is likely one of the main causes for the no-shows: The Spanish-language website did not launch until late-November, Wright said, while the non-English-language paper applications weren’t available until late-December. Currently, the website has been translated into more than a dozen languages.

Xavier Morales, executive director of the Latino Coalition for a Healthy California, said the media campaign for Covered California was effective for many groups but perhaps failed to reach the Latino community.

“The on-the-ground, personal-touch outreach has been lacking,” he said. “People who haven’t had access to health insurance in the past might be reluctant to sign up without that kind of contact.”

He believes information booths at churches, marketplaces, health clinics, schools and community centers would have influenced a greater number of Latinos to apply with Covered California.

Morales also speculates that some Latinos with family members who are living in the country without legal permission in their households may have been distrustful of applying for government-assisted health care.

“These people need to see other families like theirs who have successfully gone through the process,” he said.

Such fears, though, may be unfounded. Covered California has posted on its website a letter from the U.S. Immigration and Customs Enforcement agency assuring skeptics that information about “undocumented” family members provided by health-care applicants would not be used to enforce immigration laws.

Thirty-four states—mostly Republican led—opted not to participate in the Affordable Care Act, which required federal agencies to assist with launching their health-care programs, as the act required. This, says Wright, hindered the federal government’s capacity to oversee and facilitate exchange launches in states like California that chose to lead the process.

“You can very much trace many of the problems that Covered California experienced back to the Republican opposition to the Affordable Care Act,” Wright said.

He said that no matter how frustrating the experience of enrolling may have been for some Californians, the fact that all citizens are now eligible for coverage is a big step up.

“We should remember that a year ago, people had to fill out a 25-page medical-history questionnaire with the possibility that they could be denied for a pre-existing condition,” he said. “We can’t forget how awful the individual health-care system was before.”


This story originally appeared in the Sacramento News & Review. Independent reporting was made possible by a grant provided by calhealthreport.org.

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