Key members of the Latino Affordable Care Act (ACA) outreach coalition told Talking Points Memo the Trump administration has not reached out to begin preparing for open enrollment that begins November 1st.
By this point last year, the League of United Latin American Citizens (LULAC) and other major Latino organizations, like the National Hispanic Medical Association and National Latina Institute for Reproductive Health and Concilio, would be in the midst of enrollment frenzy. But these groups are now reporting that the Department of Health and Human Services (HHS) and the White House have not reached out to develop any kind of outreach and education campaigns specifically targeting Latinos. ThinkProgress has independently reached out to HHS, but has not yet heard back.
The news is concerning for a multitude of reasons.
First, and most obvious, health care conversations in Washington D.C. have been largely moderated by white people since November. Historically, Latinos have been more likely than white people to be uninsured and face more barriers to access. “Latinos are more likely to have low wage jobs that do not offer health coverage, and are more likely to have limited access to employer-sponsored coverage,” Kaiser Family Foundation Samantha Artiga told ThinkProgress.
The ACA was intended to provide coverage to populations that often faced coverage disparities. To a degree, the ACA did. People of color, especially non-elderly Latinos, saw significant gains in coverage. Between 2013-2015, Latinos saw the largest change in the uninsured rate among all non-elderly races:
Even so, Latinos still represent a large share of the current uninsured rate. “The challenge becomes overcoming enrollment barriers, even when people are eligible,” said Artiga. “What we learned from implementation experience, is how important on the ground one-on-one enrollment is, reaching out to this population is, and enrollment coming from someone they trust.”
The second, more obvious concern is that this is another sign of the Trump administration’s attempts to sabotage the ACA. Trump has repeatedly called to “let Obamacare implode” — especially after failed Republican repeal efforts in Congress last month. One of Trump’s first acts in office was cancelling a $5 million Healthcare.gov ad campaign. HHS has also suspended contracts with two companies that help with enrollment fairs and insurance sign-ups in 18 cities. Additionally, his administration has produced negative ACA advertisements using HHS funds, billed as testimonial videos featuring “Obamacare victims.” That’s just enrollment. Trump has threatened pillars of the ACA, including subsidy payments to insurers and insurance mandate enforcement.
And third — and often unnoticed — the marketplace needs to have a balance enrollment makeup to keep with the ACA’s goal of providing coverage to the uninsured. To do this, the marketplace needs to attract a younger and healthier population. Latinos are a key demographic in this respect; Latinos tend to be healthier and on average, are 15 years younger than white Americans. Removing them from the marketplace could seriously skew the risk pools and disrupt overall coverage under the ACA.
Signing Latinos up for the ACA presented a challenge even under the Obama administration that launched media campaigns and emphasized in-person assistance. In 2015, when nearly a third of ACA’s media budget focused on Latino media, Latino enrollment gains were modest.