MELROSE PARK, IL – Last Saturday afternoon, dozens of families interested in healthcare browsed the informational booths at the Kathleen Willis Community Resource Fair in Melrose Park, Illinois, a predominately Latino suburb of Chicago.
Ismelda Terrazas, 24, approached the Get Covered Illinois booth with her two daughters ages 2 and 6 to inquire about the new healthcare exchanges. Terrazas says this is her first time learning about the Affordable Care Act.
Though her daughters have healthcare coverage through the state, Terrazas says that neither she nor her husband have had insurance in seven years because it has never been offered by their employers. When asked what she hopes to get out of the new coverage, she says, “To be able to go to the doctor and pay less. My husband got sick yesterday and had to pay $100 for his medication.”
Though she is interested in the new exchanges, Terrazas says she doesn’t have enough information to make any decisions and would like to know about the documentation she needs in order to apply.
Daniel Olvera, an In Person Counselor (IPC) at Healthcare Alternative Systems in Humboldt Park, provided Terrazas with more information and invited her to fill out a pre-enrollment form, make an appointment, and attend a workshop.
Olvera says that the goal was to begin enrolling people by October 1st, but that was then pushed back to November 2nd because of problems with the website. Though these issues have received negative press, Olvera believes that this setbacks have had positive consequences.
“The system is still down, unfortunately, so what we’re doing is informing people of their options, let them know the different kinds of plans there are and explain all the terms we were not taught in school,” says Olvera. “It’s not necessarily a bad thing. The more informed people are, the better choices they can make. If we were enrolling, they would feel pressured to make a decision quicker.”
In Person Counselor Sam Flores says that although people have been persuaded by the negative press, he believes they simply need to be given the right information. “Basically, what I see are families and individuals that have a need for this program, they come to this program with open arms and a strong desire to, obviously, seek healthcare for themselves and their families,” says Flores.
Currently, 10.2 million Latinos are uninsured. According to Olvera, one of the main challenges in working in the Latino community is easing their suspicions. His organization primarily works with Latino families who have small children. Many of them are mixed-status families in which the parents are undocumented and the children are citizens.
“We’re helping them navigate that system. Unfortunately, the Affordable Care Act does not apply to undocumented people,” says Olvera. “There’s a lot of suspicion. After all, we’re asking for a lot of information. We’re going to be asking about their income, their date of birth, and so it makes them very uneasy when a government agency is asking them for all of this information. Our job has been to calm them down and let them know that their information is completely private and is only for the purposes of enrolling them into health care.”
Olvera says he and his fellow In Person Counselors stress that they will not have any physical copies of the families’ applications, and they make sure to show the applicants that their information is deleted from the iPad as soon as it’s submitted.
Not only do the IPCs have to gain the applicant’s trust, they must also navigate language and cultural barriers. Olvera says that although many counselors speak Spanish, many of them are not necessarily familiar with the Spanish terminology, which can lead to communication issues.
Olvera has also noticed that many Latinos, both in his family and in the community, feel like they don’t have control over their health and believe that it’s “In God’s hands.” Because of this, many of them don’t actively seek the care they need. “To let them know the immediacy of healthcare is a road block,” Olvera says. He hopes that because the ACA is focused on preventative care, people start going to their primary care physicians instead of emergency rooms.
Applicants are also worried about the costs, Olvera says. “People are also worried about their premiums going up, without taking into account that a lot of them are going to qualify for premium tax credits or cost sharing options.”
Marcos Miegha, 52, who is currently disabled and unable to work, says although he has health insurance through his wife, it’s much too expensive. He’s hoping that the new exchanges will offer a better alternative for his family. “I need to know my options– surgeries, doctor’s appointments, copays,” says Miegha, who needs frequent doctor visits. “My main concern is the out-of-pocket costs.”
Because the families they work with are primarily very low-income, Olvera says that many of them actually qualify for Medicaid or CountyCare if they live in Cook County. Governor Pat Quinn recently expanded Medicaid coverage in Illinois, which will go into effect January of 2014.
Although organizations are hoping to sign up as many people as possible, Olvera says there is definitely a push to get healthy people to enroll.
“In order for healthcare to work, you have to have a large pool of otherwise healthy adults in the system paying their premiums so people that are sick can have their healthcare covered,” he says.
But he believes that many young and people will begin to enroll when they are threatened with fines.
“It’s required by law to be enrolled. That’s one of the things a lot of people aren’t emphasizing,” Olvera says.