By Gerardo Fernandez

Alianza News

The number of uninsured Latino Californians has dropped dramatically in the last three years, especially since the implementation of Covered California, the significant increase of Medi-Cal beneficiaries, the expansion of Medicaid, and the continuing efforts to offer health insurance to individuals regardless of their immigration status. However, many continue to be uninsured, and more than half are Latinos.

California has the third highest number of uninsured people in the United States, and Latinos (the largest group in the state) still account for 59 percent of eligible for Medi-Cal but uninsured, according to surveys and data reports compiled by UCLA’s Center for Health Policy Research and UC Berkeley.

The major barriers that keep people from having access to health insurance continue to be affordability, eligibility, and cultural backgrounds. Almost half of all uninsured people (46 percent) cited high costs as main reason for not having health insurance, while 15 percent do not have insurance by choice.

“One very important factor is our culture,” said Pedro Enriquez, a Mexican-born immigrant who has lived in the United States since 1984, and a US citizen since 1998. “We (Mexicans) are slothful. We tend to act only when the problem is major. We come here to work, from Mexico or other countries, that’s our goal. So we forget about pay attention to our health, and think that the problems will go away if we ignore them.”

Another problem, according to Enriquez, is that Hispanic people do not know where to go for assistance.

“We don’t know, and we are ashamed about asking; a major problem within our culture,” commented Pedro.

Enriquez used to get insurance through his job, but seven years ago he ventured as a self-employed entrepreneur and has had health insurance on and off. In 2014 he enrolled through Covered California, but lost enrollment after not forgetting to pay the bills and is now one of the two million California workers who are uninsured.

He heard about the program through his brother, who heard through his daughter who is a nurse in San José, Calif.

“I was enrolled in that program, but I keep forgetting to keep up with the payments that are very low, I then end up paying more because of the penalties,” explained Enriquez, “I just paid about $300, so now I have to pay attention to that or I’ll pay more next year.”

Enriquez said he has not used his health insurance. “I only need dental work, but it looks like Covered California does not provide that.” The program has included dental insurance since 2015, yet Enriquez was not aware of that and continued to paid out-of-pocket when he needed dental care.

Covered California has spent over $29 million airing ads in English, Spanish, Mandarin, Cantonese, Korean and Vietnamese. Still, people like Enriquez learn about the program through word of mouth.

Two million people have registered for Covered California, although not everyone is eligible to receive health insurance premium subsidy offered by CC; because of their income, immigration status (at least at least until now), cultural or personal reasons. There are about one million undocumented people in the state who cannot enroll for Covered California, and 91 percent of them are Hispanic.

Since the implementation of the Affordable Care Act, the number of uninsured in the state has dropped by half, and it has also “significantly reduced the number of Californians on county indigent care programs,” according to Health Access California, a statewide Health Advocacy organization.

Starting in May of 2016, close to a quarter-million undocumented children will have access to the insurance marketplace through CC, and the will a new proposal might allow entire undocumented families to enroll, although unsubsidized, after a new report by the CC staff recommended moving ahead with a the proposal, Waiver 1332, that will now enter the Legislature for consideration. This waiver joins SB 10 (Lara), currently pending in the legislature, that if approved and signed by Gov. Jerry Brown, should allow undocumented people to have access to health insurance using their own money.

“Moving forward with this waiver is not just an important symbolic step toward inclusion but will also provide practical benefit and additional access for thousands of Californians,” said Anthony Wright, executive director of Health Access California, a statewide health care consumer advocacy coalition.

“[Undocumented] People right now can go and buy coverage directly from a broker or an insurance plan, but they cannot go through Covered California right now,” said Wright, “we don’t think that’s appropriate and we think that that exclusion is counterproductive. We encourage people to sign up for coverage.”

People without legal immigration status will have access to the marketplace if SB 10 is approved, but will not receive federal subsidy. However, Wright sees this as an important step of inclusion.

“We recognize that there will be many undocumented families who will have the challenge of affording the coverage, but it is a modest, but important step. It’s a symbol of inclusion, but also a practical benefit for mixed status families,” said Wright, “Over 70 percent of undocumented residents have family members who are legal.”

Gerardo Fernandez wrote this article for Alianza Metropolitan News through the USC Annenberg Center for Health Journalism Fellowship.