Enrollment groups learning from mistakes in marketing to Latinos

Facing low Latino enrollment in Obamacare plans, state exchanges and enrollment organizations plan to spend less time on the airwaves and more on the ground to reach the Latino population before the March 31 deadline, as well as for the upcoming 2015 open enrollment. They still have hopes of boosting Latino signups to respectable levels for this year.

California's state health insurance exchange, Covered California, announced last month that it would ramp up its grass-roots efforts in Latino communities by hosting in-store enrollment events and adding more bilingual certified enrollment counselors and certified insurance agents to its group of 4,180 statewide.

Though California has led the nation in enrollment, with more than 1 million residents signed up, that state, along with other states, has come under criticism for its relatively low number of Latino enrollees. Despite spending about $4.7 million on Spanish-language media between October and December and another $8.2 million after January, Covered California has struggled to pull in Latinos, who make up 60% of uninsured residents. Only about 22% of state enrollees between October and the end of February were Latino.

“No matter how much money you put into an effort, if execution is not done well, it's not going to be effective,” said Elvia Delgado, vice president of sales and marketing for AltaMed, which operates not-for-profit clinics in Los Angeles and Orange counties.

Marketing experts blame low Latino enrollment on the state's heavy reliance on traditional media strategies—digital resources and brochures translated from English to Spanish—instead of prioritizing direct personal contacts between Latino consumers and people who can answer their enrollment questions in a culturally and linguistically comfortable way.

“The major miss for Obamacare is that it really forced people into the website,” said Carlos Santiago, president and chief strategist of Santiago Solutions Group, a Los Angeles-based Hispanic market research firm. “The ads didn't give you a choice, other than a www address. There was no physical address, no 800 number.”

That creates problems for people with limited Internet access, said Shana Alex Lavarreda, director of health insurance studies at the University of California at Los Angeles Center for Health Policy Research. But the approach also fails to recognize the preference of many Latinos for personal recommendations and interactions.

“The culture is more about word of mouth and sitting down with people,” said U.S. Rep. Loretta Sanchez

(D-Calif.). In her Orange County district, Sanchez has been hosting events at high schools, public libraries and community fairs with bilingual enrollment counselors.

Similar in-person outreach efforts are taking place in Houston, where 47% of residents are Hispanic and about half are uninsured. The Gulf Coast Health Insurance Collaborative has been scheduling educational and enrollment events almost every day.

Back in California, AltaMed's two enrollment centers in Santa Ana and Los Angeles are open six days a week. People line up by 7 a.m. to get in and meet with one of the 120 bilingual enrollment counselors, Delgado said. “In the last week, we've seen 1,500 walk-ins in both locations, and our call center has seen a 60% increase in call volume with people inquiring about the ACA and seeking assistance,” Delgado said.

Though March 31 is the end of open enrollment in private plans for 2014, AltaMed plans to keep its enrollment centers open to continue helping people sign up for Medicaid throughout the year and to prepare for 2015 private plan enrollment starting in November.

Molina Healthcare, which is offering plans on the insurance exchanges in nine states, is focusing its Latino outreach in four states—California, New Mexico, Washington and Wisconsin. Molina has combined targeted advertising—ads on buses in Latino communities and in stores such as Family Dollar and K-Mart—with public presentations in English as a second language classes and in local churches.

“You have to go into the churches and into the communities to spread the word,” said Felipe Korzenny, director of the Center for Hispanic Marketing Communication at Florida State University. “It's got to be more grass roots.”

Follow Rachel Landen on Twitter: @MHrlanden