Hispanics represented nearly a quarter of uninsured, non-elderly North Carolina residents, or roughly 370,000, prior to full implementation of the Affordable Care Act. But while North Carolina had one of the most successful initial open-enrollment periods in the country, only about 7,000 of its enrollees indicated they were Latino, according to HHS, or just 3% of respondents who voluntarily provided ethnicity information.
“Right there you can see there's a real need for more outreach,” said Sorien Schmidt, North Carolina state director for Enroll America. And North Carolina is far from alone in needing more outreach to Hispanics.
“We got the low-hanging fruit,” said Sonya Schwartz, a research fellow at Georgetown University's Center for Children and Families. “There's a long way to go because the disparity was huge.”
A primary emphasis for outreach workers across the country in these closing days of open enrollment is Spanish-speaking households. Language barriers and insurance illiteracy complicate outreach efforts. Families with mixed immigration status, in which some members are eligible for benefits and others are not, further confuses matters. Enrolling through a government-run marketplace can cause trepidation in households where some members might not be in the country legally.
“Nobody wants to be the person who signed up for coverage but then got their grandmother deported,” said Anthony Wright, executive director of Health Access California, a consumer advocacy group.
Hispanics have long had the highest uninsured rate in the country. It did drop from 36% to 23% after the first open-enrollment period last year, according to a Commonwealth Fund study (PDF).
But in states that didn't expand Medicaid, such as North Carolina, the decrease in uninsured Hispanics was much less pronounced. The uninsured rate fell from 39% to 33% in states that haven't taken advantage of the ACA's Medicaid expansion provision. And uninsured rates for Hispanic adults whose primary language is Spanish also remain disproportionately high, with 30% lacking coverage.
Another potential problem for Hispanic enrollees surfaced Wednesday. HHS plans to void the coverage of 200,000 people who enrolled through HealthCare.gov because they were not able to verify information related to immigration and citizenship, according to Andrew Slavitt, principal deputy administrator at the CMS. This will be on top of the 112,000 individuals who lost their ACA coverage after failing to verify their immigration status by Sept. 30 of last year.