Beginning October 1, the Affordable Care Act will begin offering subsidized health coverage to millions of low-to-moderate income people through online insurance marketplaces. Coverage begins January 1, when the law takes full effect, and individuals who don’t have it will face a penalty that begins at $95 in 2014, rising to 2.5 percent of annual income in 2016.
The government aspires to sign up seven million uninsured and under-insured Americans in the first year of reform. The question, though, is how do you reach those seven million?
“There’s an expression in Spanish: ‘Sin salud, tu tienes nada,” said Sinsi Hernández-Cancio, director of health equity for Families USA, a nonprofit dedicated to the achievement of affordable healthcare for all Americans. “Without health, you have nothing. In minority communities, there’s too often nothing.”
The question of minority involvement is so great that U.S. Health and Human Services’s Advisory Committee on Minority Health developed a series of recommendations to tackle just that problem. Its recommendations:
1. Build upon previously successful strategies and utilize existing networks to reach diverse and underserved populations.
2. Seek tribal consultation and consult with minority communities
3. Adopt a grassroots approach to reach racial and ethnic minority communities and other underserved populations
4. Ensure culturally appropriate messaging and information
In Dallas-Fort Worth, these responsibilities have fallen to a variety of groups: nonprofits, government leaders, and community organizers chief among them. Leading the charge in Dallas County’s Hispanic population is Monica Alonzo, Dallas deputy mayor pro tem. She’s working with churches and community centers, letting them know how to help their members and visitors, and where they can be pointed for additional information. Her work is buoyed by Enroll America, a national group—with an Austin office—that helps local organizations get the word out.
“I think the most important thing is that people should ask who in their lives needs to know about this,” said Mimi Garcia, head of Enroll America’s Texas office. “If you yourself might have insurance, you know somebody that doesn’t. We want everybody to be talking about this.”
The Planned Parenthood Federation of America and the Texas Organizing Project spent six weeks in May and June knocking on more than 40,000 doors of mostly Latino households across Dallas-Fort Worth. TOP trained Planned Parenthood organizers, and the two organizations worked separately.
On a conference call last month, Families USA’s Hernández-Cancio said health and welfare disparities for minorities, particularly Latinos, are well documented, and that “minorities have struggled with chronic diseases, not just in terms of prevalence and severity of negative outcomes, but we are more likely to get sick and sicker.”
Hernández-Cancio added that Latinos would benefit from healthcare reform greatly because of the multiple, unique obstacles they currently face: mixed immigration status, language barriers, lack of prior insurance.
According to an Enroll America survey, 72 percent of Americans are unaware of the health insurance exchanges. A Kaiser Family Foundation poll found that more than half of low-income and uninsured Americans say they do not understand how the Affordable Care Act will impact them.
In California, Spanish-language cable networks Univision, Telemundo, and impreMedia have agreed with a private healthcare foundation, called the California Endowment, to encourage Latinos to enroll in the state’s health insurance exchange by sponsoring print, television, radio, and Web-based promotions.
“These leaders from California’s government, the California Endowment, and major Spanish language media outlets have joined together to help implement the Affordable Care Act here in California and to educate folks about how to sign up and shop for quality, affordable plans,” Obama said in June. “And their efforts have already shown some excellent results in the biggest insurance market in the country.”
Programs officials are considering a nationwide expansion of the effort as well.