It’s tough to sign up for Obamacare if you’re Latino. In coverage of the Affordable Care Act, we’ve sometimes forgotten who the law is for. First and foremost it’s for people with low incomes, as Drew Altman, head of the Kaiser Family Foundation, pointed out in my post Wednesday.
And lower-income Latinos may be of particular importance for the bill. Latinos are the largest uninsured ethnic group in the country, so getting Americans covered means getting Latinos covered. They are also younger and thus healthier than the rest of the US population, which makes them attractive to insurance companies and state exchanges. As PBS’ News Hour reported last week, “both here [California] and nationally, Latinos are considered key to the overall success of the Affordable Care Act.”
But as the News Hour made clear, success is proving elusive. Its piece was a good one, detailing the barriers Latinos in California face, and moving beyond the press releases from Covered California, the state’s exchange. The News Hour visited La Clinica De La Raza in Oakland, where CEO Jane Garcia said it was not a big surprise that people in the community don’t always understand what a deductible or a copay is. La Clinica’s staff has provided help to some 900 patients filling out applications, but only about 25 percent have actually enrolled. The reasons for the poor enrollment range from the application not being made available in Spanish to less-than-stellar customer service at Covered California. But as important as these translation and customer service issues may be, something else is going on.
Garcia said patients are often reluctant to reveal information about undocumented family members during the enrollment process. Many families have mixed immigration status, Garcia explained, only citizens and legal residents can get healthcare under the Affordable Care Act. It’s no surprise, then, that as families get further into the enrollment questions, they don’t complete the application. Families worry that information they share on an insurance application could be used against them for immigration purposes. What’s needed, Garcia believes, is for a high level government official to make some reassuring remarks that applying for insurance won’t negatively affect a family member’s immigration application. “I think that would go a long ways toward easing people’s minds,” she said.
The News Hour put a lot of unreported threads on the table. The New York Times has just picked up the story too, but there’s more here waiting for other journalists.
What facility fee? Connecticut Mirror health reporter Arielle Levin Becker reported on the latest twist in efforts by the state’s hospitals to extract more dollars from patients. In the last few years, “facility fees” have become common. As Becker explained in an earlier piece several months ago, these fees are charged to patients who receive procedures in a doctor’s office owned by a hospital or who use hospital-owned equipment. These fees are on top of the doctor’s bill for their services—and they can cost thousands of dollars. What’s worse, patients often don’t know about these fees until they get their bills.
On Wednesday, Levin Becker reported on recommendations by the Connecticut Hospital Association for more transparency, including a proposal that member hospitals give patients specific information about these fees if they get care at a hospital-owned medical office. State Attorney General George Jepsen praised the trade group’s effort, saying it was the first of its kind in the country, but added he will continue to pursue legislation requiring hospitals to tell patients about these fees before arriving at the facility. Victoria Veltri, the state’s HealthCare Advocate, agreed, saying making fee information available beforehand would give patients a “full and fair choice on where they choose to get their health care.” She recommended consumers ask their insurance carriers whether these fees are covered. “Not all plans cover these fees, and consumers should be able to go to a facility knowing whether they might be facing significant out of pocket costs.”