More than Eight Million Enroll in Health Care

Originally Published in the Spring 2014 LULAC News Magazine

By: Declan Kingland, LULAC Health Programs Coordinator
On Tuesday, April 1, 2014, after six tumultuous months of open enrollment, President Obama stood in the Rose Garden to proudly announce that 7.1 million Americans had enrolled in coverage through the State and Federally-facilitated Marketplaces. As of April 22, 2014, however, the number stands at eight million enrollees, which includes registrants that signed up in the special enrollment period that closed on April 15, 2014. The figure implicitly reaffirms that the program is sustainable and will provide a solid benefit, as it shatters the Congressional Budget Office’s enrollment target of six million. It is safe to say that the first enrollment period for this landmark bill ended by exceeding expectations.

As a Champion for Coverage, LULAC has worked together with Health and Human Services and other stakeholders to ensure that the Latino community has the information and resources necessary to not only get connected with the marketplace but to also choose a plan that meets needs and financial situation. As a Champion for Coverage, LULAC has engaged with its membership through a series of webinars and conference calls tailored to directly address the concerns of the Latino community. In the first few weeks of Open Enrollment, LULAC held a Bilingual Health Town Hall that convened national leaders to discuss the benefits that Affordable Care Act implementation provides to the Latino community. LULAC livestreamed the event at www.LULAC.org/live to maximize the national reach. In the following months, the video was viewed thousands of times. When coupled with our Health Care Reform: Latinos Living Healthy and the Affordable Care Act manual and several fact sheets – that were not only distributed to our membership in paper form but also hosted online – LULAC grew to be one of the primary sources for information about the ACA for the Latino community.

Members Steer Local Outreach

LULAC prides itself on its ability to raise issue-focused grassroots awareness to directly impact communities through events hosted by our trained Health Ambassadors and other interested community leaders.

In late 2013, select Councils from across the country took part in the soft launch of www.CuidadoDeSalud.gov. As they participated in the enrollment process, members provided feedback, which proved integral to a smoother user experience when the page was officially launched.

To add to this grassroots activation component of our campaign, LULAC together with our partners, set out to host a series of Latino Enrollment Summits in states with high rates of Latino uninsurance. Through these summits, uninsured Latinos and other community members were directly connected with Spanish-language assistance. By the end of Open Enrollment on March 31, 2014, LULAC and partners held 65 summits, at which thousands of Latinos enrolled in affordable coverage options.

LULAC’s commitment to these summits began at the start of the outreach process, when we hosted the partnership’s pilot enrollment summit at our LNESC Technology Center in Dallas, Texas. During that six hour period alone, nearly 50 family members came in to sit with trained in-person assistors to start the process. People that had never had health insurance were excited by the prospect, which made word spread faster. Gaining traction as the deadline neared, the enrollment summits grew in attendance as hundreds met with Navigators or Certified Application Counselors to undergo the application process.

In Texas, LULAC hosted enrollment assistors in the local LULAC Houston Council office during the weeks leading up the enrollment deadline and also hosted weekly Enrollment Summits on Saturdays. Office of Personnel Management Director Katherine Archuleta, the first Latina to hold the position, joined LULAC’s Houston Council on March 15, 2014, and held a candid discussion at a community roundtable of Latina members who were able to understand first-hand the enrollment process.

“People are confused, but they are getting the information.” said Agnes Rivera Garza, LULAC Deputy Director of Women. “When people hear about the process directly from a leader like this, it makes the information more official. The fact that she took the time to come to our center makes the process more personal.”

Cecilia Muñoz, Assistant to the President and Director of the Domestic Policy Council, also met with Houston LULACers in the following weeks to continue to address community concerns of individuals looking to enroll.

Post-Enrollment Period Next Steps for LULAC

Despite these efforts, LULAC is concerned that far too many Latinos remain without coverage.

“Our work has not concluded even though open enrollment for 2014 has ended,” said LULAC National Director Brent Wilkes. “The Latino community has a track record of being slow to adopt new government programs, and we fear that the Affordable Care Act may have been negatively impacted by this tendency. Our members will continue connecting with individuals who were unable to take advantage of the 2014 Enrollment Period, so that they have ample opportunity to do so next year.”

Late March 2014, LULAC sent a letter to President Obama and then Secretary Kathleen Sebelius of the Department of Health and Human Services, urging each to demonstrate flexibility with the implementation of the tax fines associated with individual mandate. In the letter, LULAC encouraged the Administration to address the Latino population that remains uninsured – by extending the open enrollment period and/or by waiving the individual mandate for individuals who were unable to apply due to a good cause or refunding it for those who apply for coverage in 2015.

LULAC was glad to see that our first suggestion was taken into consideration when the Special Enrollment Period from April 1, 2014 - April 15, 2014, was announced, allowing individuals who had a variety of hardships, including technical difficulties with the enrollment process, to continue to access the enrollment website to gain coverage.

This extra time is expected to have helped Americans find coverage in the states that are not expanding Medicaid. In some states, governors have explicitly refused to expand the Medicaid coverage that is granted under the ACA, which leaves over one million Latinos uninsured. In fact, 80% of Latinos who fall into the coverage gap reside in Texas and Florida, states in which many LULAC members are active. As states can opt in at any time, LULAC is redoubling efforts to emphasize and implement the Medicaid expansion program. Because the federal government will cover 100% of additional costs of expansion for the first three years and 95% of additional costs after that point, hundreds of thousands of Latinos could receive the health insurance coverage that they need at little or no cost to the applicant or to the state.

Upcoming Legislative Action

LULAC also supports a bill that would remove barriers to health coverage, access that is currently denied under the ACA. Titled the Health Equity and Access Under the Law (HEAL) Immigrant Women and Families Act, the bill was introduced by Congresswoman Michelle Lujan Grisham of New Mexico, a guest speaker at the LULAC Legislative Conference health panel in February at the nation’s capital.

Under the HEAL Immigrant Women and Families Act, lawfully present immigrants would be given access to Medicaid and the Children’s Health Insurance Program (CHIP) by eliminating the current five-year bar on enrollment and the outdated and restrictive list of “qualified” immigrants. Removing these barriers can help both mother and child as lawfully present immigrants will have access to care and their own doctor, instead of relying on emergency room for care. Latinas are disproportionately affected by cervical cancer, an illness that, through regular preventative care visits, can be screened and treated before developing into a serious illness. In addition, Latino children are more than 50% more likely to have an unmet medical need and almost twice as likely to have that unmet medical need due to cost; CHIP could mitigate these effects. The passage of the bill can go a long way towards addressing the health disparities that exist in the Latino community.

Take Full Advantage of New Coverage

During the coming months, LULAC will continue to advocate for increased access to care while also working to ensure that everyone takes full advantage of their available coverage. Through the Enrollment Summits we have seen that, in some communities, there is still a considerable amount of misinformation and apprehension when it comes to the Affordable Care Act.

For individuals who are gaining coverage for the first time or have more extensive coverage options now than they had before, it is important that they not only know the full extent of the preventative care but that they take full advantage of it.

“Having coverage is just the first step; the important part is utilizing that coverage to improve your health,” said LULAC Director of Policy and Legislation Luis Torres. “Let’s work together to ensure that all uninsured Latinos gain access to care so that we can remove disparity from the end of Latino health.”