Even as California leads the country by signing up uninsured people, Covered California has stumbled by failing adequately to extend coverage to Latinos, the largest uninsured population in the state.
Covered California executive director Peter Lee’s persistent efforts to “accentuate the positive” and “eliminate the negative,” as the song goes, should not mask that hard reality. The first major deadline for coverage was Dec. 31. California’s target for overall enrollment was 611,000; the number enrolled was 498,794.
Exchange officials expect a surge of enrollment by March 31, the end of the open enrollment period for this year. A surge probably will occur. But to reach the target of 1.3 million, more than 800,000 people will have to sign up. That means the state must do a better job of reaching Latinos, who account for 59 percent of the state’s uninsured population.
Critics have pointed to technical issues, such as the Spanish-language version of the website not working until late November, and lack of a Spanish-language paper application until late December.
These startup problems undoubtedly will be repaired for the 25 percent of Latinos who are Spanish-language dominant and generally older.
That alone won’t solve the problem: 58 percent of California Latinos are bilingual and 17 percent speak English-only, according to the health exchange’s 2012 marketing plan. The exchange has boosted spending on television and radio ads in English and Spanish.
But mending the website and doing more advertising is no substitute for addressing the real issue, which is to connect with target communities in person. Word of mouth from trusted sources matters more than ads, especially among people who never have had insurance and don’t use the Internet.
Further, in a state with a long tradition of immigration, a major issue is that many people come from “mixed-status” immigration families. Nearly half of California’s immigrants are U.S. citizens; 26 percent have other legal status, including green cards and visas.
In-person help is needed to work through these complexities.
The dearth of boots on the ground is reflected in 40-minute average wait times at call centers. It also is reflected in the low numbers of enrollment counselors. Covered California originally had plans to train 20,000 enrollment counselors by Dec. 31; the actual number was 3,000.
As a group, Latinos are younger and healthier than the general population. The state needs Latino enrollment to make the new insurance pool work as intended, with a mix of old and young, healthy and sick people.