Though they make up roughly a third of the state’s population, Latinos account for nearly two-thirds of the more than 6 million Texans without health insurance. As a result, proponents of the Affordable Care Act in Texas are specifically targeting Latinos in their efforts to enroll people in a federal insurance marketplace aimed at helping the uninsured find coverage.
But in the two weeks since the marketplace opened, health care advocates across the state have encountered common obstacles getting Latinos registered, including limited access to computers and a lack of email addresses. Advocates are developing community-based strategies to overcome these obstacles, and to ensure that Latinos do not miss out on insurance options available through the Affordable Care Act, which requires most people to carry coverage beginning in 2014.
One strategy is reliance on promotoras — health counselors, often women, who provide education on health coverage options in Spanish-speaking communities.
“Just being bilingual isn’t enough,” said Frank Rodriguez, executive director and founder of the Latino Healthcare Forum, which hopes to use promotoras to reach more than 50,000 uninsured people in the Austin area over the next six months. “What we’re doing is recruiting people from the community that know the norms and the customs of the people.”
Angelica Noyola, one Austin community activist hired as a promotora by the Latino Healthcare Forum, said that when she asks her neighbors about the Affordable Care Act, she hears many false rumors: that anyone who works for a small company will be laid off, that the federal government will put people in jail who don’t have health insurance.
“There’s so much incorrect information out there,” she said. “It’s quite scary to a lot of individuals.”
The online marketplace the federal government launched on Oct. 1 offers dozens of health plans and sliding-scale tax credits to help poor individuals and families purchase coverage. Latinos account for roughly 1.7 million of the 2.8 million Texans estimated to be eligible for such tax credits, according to the La Fe Policy Research and Education Center in San Antonio. There are also tax penalties for not purchasing health insurance.
Rodriguez said there are two daunting aspects of the federal marketplace for Latinos. He said it is particularly difficult for Latinos to address the questions on taxes and projected income required to sign up for coverage. And he added that many Latinos are hesitant to commit to a major spending decision like health insurance.
“Affordability is a really subjective term for Latinos,” Rodriguez said. That is why his organization’s campaign to get them enrolled in the marketplace is relying on terms like “security” instead, he said.
Noyola said that many Latinos in Texas are living paycheck to paycheck, but that when it “comes to health and each other, they pull together.” She said many stand to benefit from the health plans offered in the marketplace, because they will be financially protected and have access to preventive health services.
While some uninsured Latinos seek out assistance organically, Rodriguez said that in his experience, most will need to be contacted five to seven times — by way of a phone call, a flyer or a sit-down conversation — to get them to enroll in the federal marketplace.
“The Latino community likes to have that face-to-face conversation when they’re buying something as important as health care,” said Arturo Aguila, an organizer for Border Interfaith in El Paso, which has created a similar community-based strategy to educate uninsured Latinos on federal health reform. With the help of local rabbis, priests and pastors, Border Interfaith has already held seven events to educate nearly 500 people on the Affordable Care Act.