Dec. 20--GILROY -- It's not that Adan Lopez hasn't heard about the new federal health care law.
By now, the 32-year-old self-employed, uninsured Gilroy worker is familiar with Covered California, the state's health insurance exchange, through Spanish-language television and radio -- it even pops up on Internet sites he visits.
He just hasn't gotten around to signing up for it. And he's hardly alone.
In a state where two out of five people are Latino, a worrisome trend has surfaced in the rollout of the Affordable Care Act: Few Latinos have enrolled. Of the 109,296 California residents who registered for a health insurance plan by Nov. 30, only 13 percent were Latinos.
In many ways, Covered California fumbled its outreach by failing to offer Spanish-language paper applications and not hiring enough Spanish-speaking enrollment counselors, exchange officials admit.
"I'm very concerned," said state Sen. Ed Hernandez, D-West Covina, who chairs the Senate Committee on Health and believes the problem needs to be attacked much like a political campaign.
"Rather than waiting for them to come to the website, we need to go to where people are to get them signed up. If Covered California is going to be successful, a big part of that success will be the enrollment of the Latino population."
Of the state's 5.3 million people who are uninsured or underinsured, 1.6 million are Latinos living here legally who are eligible to apply for health insurance on the exchange, and Covered California says most of them would qualify for a subsidy. The majority of the state's Latinos are not eligible because they already receive health insurance through their employer or a government program like Medi-Cal, or because they entered the country illegally.
Santiago Lucero, a Covered California spokesman, acknowledged that "we are not happy" about the paltry numbers, "but we know and believe that we have planted the seed and those numbers will go up."
While an expensive outreach and media campaign appears to be having some impact on Latinos, the exchange has found itself stumbling over its own coordination problems.
On Thursday, Covered California officials once again acknowledged the challenge, saying they have "doubled down" their spending on radio and digital marketing to reach more Latinos and Spanish speakers, particularly in Los Angeles, leading up to Monday's application deadline for a health insurance plan that would start Jan. 1. Open enrollment ends March 31 for coverage to start next year.
Still, Lucero said there were not enough Spanish-speaking enrollment counselors or bilingual call-center operators when the exchange opened Oct. 1. That number is finally expanding, and 60 percent of the counselors now speak Spanish, as do more than 12 percent of certified insurance agents.
The Covered California website includes a Spanish-language section, but a recent survey showed only 52 percent of Latino households in California have broadband Internet access at home. And even if they have access to a computer, many Latinos would prefer to sign up in person with assistance, according to those -- often Latinos themselves -- helping to enroll them in a health plan.
Instead, they want paper applications in Spanish.
"Once we release the paper applications in Spanish," said Lucero, "it will drive the numbers up." But Covered California officials said those applications won't be available before Monday's deadline. Moreover, the exchange is urging anyone trying to make the deadline to either apply online or get assistance from a certified enrollment counselor or insurance agent.
The process of signing up for health insurance "is a very scary thing for many Latinos," said Tamara Centeno, a certified health exchange educator in the East Bay who works with Vision Y Compromiso, a group focused on improving the health of the Hispanic community. "It's all about trust. They need to see the face of the person" when making transactions, she said.
As Dolores Alvarado, CEO of the Community Health Partnership, an organization of nonprofit community health centers and clinics in Santa Clara and San Mateo counties, put it:
"A computer doesn't talk back to you or counsel you," she said. "I have been in the business of health care since 1976, and I can tell you there is nothing like the personal touch."
In Alameda County, Supervisor Wilma Chan, who chairs the board of supervisor's health committee, attributes the low number of Latino sign-ups to an outreach effort that didn't get off the ground there until the past month.
"It took time to staff up and hire people and get trained," she said. Chan also noted that in homes where one person is a legal resident and the spouse or relatives are not, there may be some hesitancy about signing up for a government plan.
Covered California says that in addition to the109,296 individuals enrolled in a health care plan on the exchange as of Nov. 30, 179,000 people statewide were to determined to be likely eligible for Medi-Cal, the state's health care program for the very poor. As it happens, Lopez would probably fall into the Medi-Cal group next year. But after that, he expects his income might be enough to qualify him to sign up for a plan on the exchange.
Still, between juggling two jobs, he has yet to investigate either option.
"I don't have a lot of free time," said Lopez, who works at a body shop and recently opened Café Revolucion, a Mexican food restaurant in downtown Gilroy.
One trait Lopez said Latinos share with many others is procrastination: "A lot of Latino people, I will say, will probably wait until the last minute to sign up."
Contact Tracy Seipel at 408-920-5343. Follow her at Twitter.com/taseipel.
(c)2013 the San Jose Mercury News (San Jose, Calif.)
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Original headline: Few Latinos signing up for California health insurance exchange
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