On Obamacare, we still have work to do in Texas

Photo by Eddie Seal

More than two months after a key enrollment deadline, debate over the Affordable Care Act has finally settled down.

During this rare respite, we should remember why the law was passed in the first place: to remove the obstacles that have kept millions of Americans from obtaining health insurance.

In Texas, which still has the highest uninsured rate in the nation, groups like ours, the Texas Association of Health Plans, share that same goal. Of the 3.1 million Texans eligible for coverage through the health care exchange, 733,757 have enrolled, according to the U.S. Department of Health and Human Services. This is a great start, but we still have work to do.

The rule changes and delays that plagued the Affordable Care Act’s first open-enrollment period stirred fears of instability in the health care marketplace — and, more worryingly, confusion among customers.

This confusion could prove especially harmful to Hispanics in states like Texas. Missteps like the troubled rollout of a Spanish-language marketplace website and a lack of bilingual health care navigators have muddled efforts to educate and enroll Hispanics — the largest and youngest minority group in the U.S., and the most likely to be uninsured. More than a third of Hispanics in Texas — about 3.5 million — are uninsured, accounting for 56 percent of the state’s uninsured population.

The White House has estimated that for every three older Americans who sign up for the Affordable Care Act, better known as Obamacare, it needs at least two younger people to enroll for premiums in the marketplace to stay affordable. Enrolling more Hispanics — whose median age is 27 — could provide a huge influx of young, healthy adults into the health care system.

Because of those factors, low Hispanic participation in the Affordable Care Act could be the law’s biggest early-stage stumble.

According to the Commonwealth Fund, a health care research group, only 49 percent of Hispanics who may be eligible to receive subsidies for health insurance were even aware of the marketplace in their state, compared with 63 percent among all Americans.

A number of social, cultural and economic factors explain the struggle to court uninsured Hispanics. Surveys, for instance, show that Hispanics are most comfortable with in-person assistance when signing up for insurance in the health care exchange. But bilingual navigators remain scarce, and Obamacare enrollment efforts have focused more on technology.

This isn’t just a Hispanic issue, though. Minorities throughout the U.S. are also enrolling in lower numbers because of similar language and cultural barriers, misinformation about eligibility, and other hardships such as food and housing insecurity.

Lagging enrollment among these minority groups has triggered a renewed commitment to ramp up outreach programs in Texas. The marketplace is currently stable and offers a generous set of benefits and competitively priced options. The myths and confusion about applying for health insurance must be dispelled, and we must work together to deliver clear information to Texans looking to obtain coverage in the next enrollment period. We must be a part of the solution.

Disclosure: The Texas Association of Health Plans was a corporate sponsor of The Texas Tribune in 2011 and 2013. A complete list of Texas Tribune donors and sponsors can be viewed here.

David Gonzales

CEO of the Texas Association of Health Plans

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