With less than two months left to register for health insurance as mandated by a new federal law, the proverbial clock is ticking for millions of Americans across the country who remain uninsured to date.
The March 31 deadline is steadily approaching, and those who fail to enroll in the health care options offered under the Affordable Care Act (ACA), otherwise known as ‘Obamacare,’ are subject to penalty—which at the minimum will sum up to $95 for the year 2014, but could potentially be more depending on income and family size.
For many community healthcare providers, the threat of a one-time fine is the lesser evil that accompanies the healthcare reform—even worse for those who fail to meet the deadline, they say, is the threat of being barred from insurance plans offered by the state-run marketplace exchange, Covered California (Covered CA)—and vital health services— for the remainder of the year.
“We are making a huge push because from my perspective, its a matter of life and death,” said Dr. Esteban Lovato of the La Loma Medical Center in east Oakland. “If a woman goes a year without a mammogram or a pap smear for preventative care, or an elderly person without a colonoscopy … the ensuing eight months until 2015 really could make all the differences in their lives.”
Covered CA representatives addressed a small audience on a rainy afternoon in the Mission Branch Library on Feb. 8—hopeful that their workshop would help answer questions and urge people to take advantage of the new healthcare options before it is too late.
“Before this new law took place, there were a lot of reasons why people were uninsured—some were denied by health insurance plans because they had pre-existing conditions, for others it was unaffordable,” said Covered CA Education and Outreach Coordinator Caitlin Chan, who ran the workshop at the library. “If you don’t have insurance, the new law is great news because there are a lot more affordable options now than there were before.”
Chan explained patiently the benefits of the new law to a handful of attendees: guaranteed coverage, no annual limits on doctor visits, and that coverage can no longer be determined by factors such as health status or gender, among other improvements. Another Covered CA representative translated Chan’s words into Spanish every time she paused.
“Enrollment can take place online, over the phone or in person,” said Chan, while passing out a list of local enrollment counselors. “The application is supposed to be really easy to walk through.”
Though the law, which had all of its components enacted on Jan. 1 of this year, is a measure to ensure that all Americans have access to affordable health insurance, certain populations remain uninformed about its implications, while others, such as undocumented immigrants, are entirely excluded.
Healthy SF, San Francisco’s low-income health program, will continue to service undocumented immigrants and those who are not eligible to enroll for health insurance under Covered CA, including currently incarcerated individuals.
Since these populations are not included in the healthcare reform, they will be exempt from the penalty and other obligations under the program.
“Unfortunately, the undocumented are not built into the law so there isn’t a safety net for them,” said Chan. “San Francisco and Alameda and some other counties are doing a lot more to support county programs such as Healthy SF. There are resources in a lot of communities, but some of them are not well known about.”
Healthy SF is not considered an actual health insurance because patients are limited to community clinics that support it. Medi-Cal is also available for the undocumented.
“We got the statistics of who is enrolled (in Covered CA) so far, and that the Latino population hasn’t been reached as much,” said Chan, admitting that enrollment among Latinos has been lagging. “We are grantees of the outreach and education program, and have been receiving more instruction by the state to focus more on bilingual and spanish in order to reach this population—we are trying to find more ways to access the community.”
Many community leaders point to a language barrier and general fear of reprisal from the government—perhaps because some Latino families have undocumented members—among the Spanish-speaking community as reasons for not taking advantage of the healthcare reform.
“We thought that here at the library, we would get a lot of questions, but we found that a lot of people are reluctant to come clean and say ‘we don’t have health insurance,’” said Ricardo Antoni, adult services librarian at the Mission Branch Library. “Maybe they are embarrassed or afraid to step forward.”
“As far as outreach, I think we have done everything we could have done from the library’s standpoint, and also Spanish-speaking TV channels like Telemundo and Univision…to inform people,” Antoni added.
Despite an increase in outreach targeting Spanish-speakers in recent months, Dr. Lovato believes that these efforts are too “late in the game,” and that outreach and informational campaigns about Obamacare have not been sufficient in the Latino communities.
That is why he and his staff are “stepping up” and personally reaching out to their Spanish-speaking patients, many of whom he said remain ill informed about how the new reform will affect their lives.
“Our office has been taking the slack by doing outreach to our own patients. We are making phone calls, we have posters, and a countdown calendar,” said Dr. Lovato. “We have started an outreach campaign because the information is there, its just not getting to the patients for some reason.”
Referring to figures released by Covered CA, Dr. Lovato stated that 46 percent—nearly half—of the 2.6 million Californians eligible for federal premium subsidies are Latinos, yet recent polls showed that only 20 percent of those who have enrolled so far are Latino.
“Latinos represent more than half of California’s 7 million uninsured people,” said Dr. Lovato. “We have a lot of work to do.”
Open enrollment for Covered CA started Oct. 1, 2013 and will end March 31, 2014.