By RICARDO ALONSO-ZALDIVAR
Associated Press
The nation's largest minority group risks being left behind
by President Barack Obama's health care overhaul.
Hispanics account for about one-third of the nation's
uninsured, but they seem to be staying on the on the sidelines as the White
House races to meet a goal of 6 million sign-ups by March 31.
Latinos are "not at the table," says Jane Delgado,
president of the National Alliance for Hispanic Health, a nonpartisan advocacy
network. "We are not going to be able to enroll at the levels we should be
enrolling at."
That's a loss both for Latinos who are trying to put down
middle-class roots and for the Obama administration, experts say.
Hispanics who remain uninsured could face fines, not to
mention exposing their families to high medical bills from accidents or
unforeseen illness. And the government won't get the full advantage of a group
that's largely young and healthy, helping keep premiums low in the new
insurance markets.
"The enrollment rate for Hispanic-Americans seems to be
very low, and I would be really concerned about that," says Brookings
Institution health policy expert Mark McClellan. "It is a large population
that has a lot to gain ... but they don't seem to be taking advantage."
McClellan oversaw the rollout of Medicare's prescription drug benefit for
President George W. Bush.
The Obama administration says it has no statistics on the
race and ethnicity of those signing up in the insurance exchanges, markets that
offer subsidized private coverage in every state. Consumers provide those
details voluntarily, so federal officials say any tally would be incomplete and
possibly misleading.
But concern is showing through, and it's coming from the
highest levels.
"You don't punish me by not signing up for health
care," Obama told Hispanic audiences during a recent televised town hall.
"You're punishing yourself or your family."
Like a candidate hunting for votes in the closing days of a
campaign, Obama was back on Hispanic airwaves Monday as Univision Radio
broadcast his latest pitch.
"The problem is if you get in an accident, if you get
sick, or somebody in your family gets sick, you could end up being
bankrupt," the president said.
Only last September, three of five Latinos supported the
national overhaul, according to the Pew Research Center. Approval dropped
sharply during October, as technical problems paralyzed the health care rollout
and the Spanish-language version of the HealthCare.gov website. Hispanics are
now evenly divided in their views.
A big Gallup survey recently showed tepid sign-up progress.
While the share of African-Americans who are uninsured dropped by 2.6
percentage points this year, the decline among Hispanics was just 0.8
percentage point.
In California, where Latinos account for 46 percent of those
eligible for subsidized coverage through the exchange, they represented 22
percent of those who had enrolled by the end February and had also volunteered
their race or ethnicity. The state is scrambling to improve its numbers in this
week's home stretch.
Experts cite overlapping factors behind disappointing Latino
sign-ups:
— A shortage of in-person helpers to guide consumers.
"In our community, trust and confidence is so important — you want to make
sure it's OK before you share all this personal information," Delgado
said. There's been a lack of "culturally sensitive" outreach to
Latinos, added Rep. Lloyd Doggett, D-Texas.
— Fear that applying for health care will bring unwelcome
scrutiny from immigration authorities. The health insurance exchanges are only
for citizens and legal U.S. residents, but many Hispanic families have mixed
immigration status. Some members may be native born, while others might be here
illegally. Obama has tried to dispel concerns, repeatedly saying that
information on applications will not be shared with immigration authorities.
—The decision by many Republican-led states not to expand
Medicaid, as they could under the law. With states like Texas and Florida
refusing to expand Medicaid, many low-income Latinos will remain uninsured.
However, Medicaid expansion is separate from coverage on the exchanges, which
is available in every state. Latinos don't seem motivated to sign up for that,
either.
— Technical difficulties that delayed the federal
government's Spanish-language enrollment site. CuidadoDeSalud.gov has also had
to cope with clunky translations.
Delgado's group is asking the administration to extend the
March 31 deadline for Latinos who got tangled up in website problems. Officials
say that's not likely. However, they haven't ruled out a little extra time for
anyone who started an application but wasn't able to finish by the deadline.
A recent enrollment outreach event in Houston drew Mary
Nunez, who works with her self-employed husband in the florist business. They
have been uninsured since she lost her job last year. In that time, she's only
been to a doctor once — to get a refill on blood-pressure medication.
"Praise the Lord, we haven't gotten sick," said
Nunez, adding that she knows luck eventually will run out.
She made an appointment for in-person assistance to review
her options on the Texas exchange. But since the couple's income fluctuates
from month to month, she was uncertain how much they could afford. A deadline
is looming, she noted, and "Hispanics always leave it for the last
minute."
