Obamacare’s Hispanic enrollment is low, new HHS report shows

Hispanics, a key demographic for the Affordable Care Act, did not appear to sign up for health insurance through the law's marketplaces at the rate the Obama administration had hoped, according to new government data.

The enrollment report from the Department of Health and Human Services, the first national data on the ethnicity of Obamacare enrollees, and sheds new light on the health-care law's efforts to reduce uninsured rates among minority populations who disproportionately lack health coverage.

Hispanics historically have had the nation's highest rate of uninsured, with 29 percent without coverage in 2012, according to Census Bureau figures. About 17 percent of African Americans, 15 percent of Asian Americans and 10 percent of whites did not have health insurance that year.

Over the past seven months of enrollment, attention has focused on Hispanics because they represent a huge proportion of the nation's uninsured. Moreover, the population skews younger than the American public at large, making them key to the White House's goal of ensuring robust enrollment by healthy young people.

According to the report, people who identified themselves as Latino accounted for 7.4 percent of total sign-ups in the 36 states with federal-run exchanges. The administration cautioned, however, that it did not have ethnicity data for about 31 percent of people selecting coverage on the federal marketplaces. The report also didn't include data from the 15 state-run exchanges, and it doesn't account for people who may have obtained coverage through Medicaid.

More than 8 million people in total selected health plans on the Affordable Care Act exchanges, the White House has said. According to the enrollment report, young adults between 18 and 34 years old accounted for 28 percent of sign-ups nationwide.

HHS also said Medicaid and the Children's Health Insurance Program grew by 4.8 million people between the Oct. 1 opening of the health insurance marketplaces and March. HHS didn't say how much of the enrollment growth in the programs is attributable to the ACA's Medicaid expansion.

When excluding people who didn't report ethnicity, Latinos accounted for 10.7 percent of those signing up for coverage in the federal exchanges. That's less than the population of Latinos eligible to sign up for exchange plans, according to HHS data. Whites also signed up at proportionally lower rates, but African Americans and Asian Americans signed up at higher rates.


(Department of Health and Human Services)

Sign-ups among Hispanics lagged initially, notably in California, which has been viewed as a bellwether for the nation because the state embraced the ACA and because it historically has had a very large and diverse uninsured population. The state spent millions targeting Latinos for sign-up, but participation was dismal late last year. Advocates complained that there were not enough Spanish-speaking counselors and that legal U.S. residents feared alerting the government to their unlawfully present relatives.

Advocates outside of California noticed a similar trend, attributing the lagging Hispanic enrollment to a delay in the Spanish-language version of the federal enrollment Web site, HealthCare.gov, as well as technical difficulties experienced by people in families with mixed immigration status who were trying to enroll on the federal marketplace.

But in what was viewed as a promising sign nationally, enrollment among Latinos in California surged late in the enrollment period, with the community representing an estimated 28 percent of sign-ups overall by the end of March. HHS reported a spike in Latino enrollment in the federal exchange states near the end of the sign-up period.

HHS released the newest enrollment numbers a day after Republicans on the House Energy and Commerce Committee issued a report saying just two-thirds of people who signed up for coverage on 34 federal-run insurance marketplaces had actually completed enrollment by paying their first month’s premium as of April 15. Supporters of the law said the committee’s report is misleading because those who signed up during the late enrollment surge weren’t yet required to pay when the insurers responded to the Republican lawmakers.

Obama administration officials have repeatedly refused to provide information about how many people paid for the plans they selected, but they pointed to public comments from insurers indicating tat between 80 percent and 90 percent of enrollees  have paid.

 

Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.
Sandhya Somashekhar is the social change reporter for the Washington Post.
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