Counselors help translate Obamacare
- For those who have opted for virtual enrollment%2C the federal enrollment website has a Spanish side.
Jose Sanchez heard about it from his aunt, who heard about it from a trusted friend at Westside Family Healthcare in Wilmington.
Then, earlier this week, Sanchez went to hear about it – in person – from Jose Cruz Gonzalez, a gregarious, savvy and trusted financial aid assistant for Westside. Staffers there say clients will wait for hours to meet with Gonzalez, and come back later if he's not available.
Trust – confianza – is an essential part of translating Obamacare, as the nation's new health insurance is called, no matter which language is involved. Relational trust is especially powerful in Hispanic/Latino cultures, so certified application counselors – including Westside's Gonzalez and La Red's Ruben Rocha – are critical to the process.
"They trust us, and they come to us for good advice," Rocha said last week, when U.S. Sen. Tom Carper, D-Del., visited La Red's Seaford clinic. "That's what we do."
Gonzalez, whose roots reach to Ecuador, walked Sanchez through the enrollment process and into his first health insurance policy since he arrived in the United States from Mexico seven years ago.
And then Sanchez walked through two Westside clinic doors and made his first appointment with a doctor in the United States.
Confusion
No one can say how many Obamacare enrollees speak Spanish as their first language. It is not tracked, state and federal officials say. And many languages other than Spanish are represented in the millions who have applied for plans through the marketplace. Westside has a marketplace guide who speaks Haitian Creole, and all those with state and federal marketplace credentials have access to a federal language line to help with translations if needed.
But much more could have been done to reach Delaware's Spanish-speaking population on this, said Kevin Andrade, owner of Georgetown-based radio stations Maxima 900 AM and 106.1 FM, which offer 24-hour news and programming to the Spanish-speaking population of Delmarva.
Andrade, a native of Ecuador, hosts a daily morning show, "Hola in the Morning," but said he had difficulty finding someone to come on the air to discuss the new insurance and answer questions. He started asking six months ago, he said, and finally got someone a few weeks ago. The enrollment deadline for 2014 is midnight Monday.
"They did the best they can," he said, "but with the time they had, they wasted a lot of time and money."
The issues are complicated, the stakes are high, and many people still don't know how the Affordable Care Act affects them. Others are just confused, Andrade said.
"I was at a meeting not long ago with 20 people – all well-educated, all professionals – and I asked them, 'Can someone explain what is this Obamacare about?' " he said. "No one had an answer. ... They don't want to be dependent on the government, and they think this is welfare or Medicaid."
Andrade said marketplace guides will be available Saturday when his radio station and several other broadcasters host a massive job fair – they expect 4,000 people – at Sussex Academy in Georgetown from 11 a.m. to 4 p.m.
Words matter
Westside's Gonzalez, who is from Puerto Rico, has a degree in education.
With an educator's skill and patience, he works from basic information, explaining what insurance is and how it works, to more specific concepts – what a premium is (monthly payment), what a deductible is (what they'll pay before insurance starts to pick up the costs) and how they are related (the higher the premium, the lower the deductible).
Rocha said it takes him an average of two hours per person to explain the options to those who have never had insurance, might be suspicious of government programs, and/or don't know how to navigate the system.
"Buying health insurance is not simple," he said. "You have to make decisions all along the process."
And you must be savvy to word choice and to the fears that many bring to the topic.
Maria Cabrera, a native of Puerto Rico and a member of Wilmington City Council, works as a federal insurance marketplace navigator with Chatman LLC.
She tries not to emphasize that word "federal," though. It can make people nervous.
"Before you start on that, you have to remember – who are the federales?" she said. "They come in, arrest you, they work for the government, some are corrupt. I can't tell them I'm a federal or, 'Be careful, she might report you.' "
Undocumented residents are not eligible to enroll in any of these plans, but those fears might prevent them from getting coverage for their children, who may be eligible for CHIP, the Children's Health Insurance Program.
It should be widely reported that no information provided during enrollment can be used to deport anyone, she said.
"We really have to strategize more on how to do outreach and do more marketing," she said.
Online tools
For those who have opted for virtual enrollment instead of a face-to-face meeting, the federal enrollment website has a Spanish side – www.cuidadodesalud.gov – but its launch was delayed several months during the now-infamous technical difficulties of the parent site, www.healthcare.gov.
"I tried three times to enroll myself," said Andrade, who will have insurance that also covers his wife and two children.
"It's so expensive, but we try to maintain health through preventive maintenance. Thank God, we don't have any issues."
Rocha praised the multilingual tools on the ACA website, and at insurance company sites, too, but said it can be harder for clients to get a Spanish-speaking insurance rep on the phone than it is to get Spanish-language information on the site.
Gonzalez said he sees areas where the process could be improved.
One example, he said, is that the enrollment forms don't recognize tax information numbers – TINs – which prevents the system from recognizing some dependents and limits the discounts a person might qualify to receive.
The good news
But when the options are clear and enrollment information gets where it needs to go, many are getting insurance – and some are getting good news about subsidies.
Cabrera said she had enrolled 61 people at last count. Gonzalez believes he has enrolled about that many, too.
"Latinos aren't the ones crying and screaming and balking about this," Cabrera said.
"They're so happy to have insurance."
Sanchez was eligible for a good subsidy, Gonzalez said, and will pay less than $100 a month for his plan, including dental care.
Such encounters make the long hours and complicated conversations well worthwhile, Gonzalez said.
"What I like at the end of the day is that you see the difference you make," he said. "I really love what I do."
Contact Beth Miller at (302) 324-2784 or bmiller@delawareonline.com. Follow on Twitter @BMiller57. Contact James Fisher at (302) 983-6772, jfisher@delawareonline.com or on Twitter @JamesFisherTNJ.
Insurance marketplace information
• Open enrollment closes Monday for coverage in 2014. Enrollment for 2015 begins Nov. 15.
• Those who can afford insurance and choose not to get it will face tax penalties, starting at $95 (or 1 percent of annual income, whichever is higher) and rising sharply in subsequent years.
Obamacare enrollment events
FRIDAY
New Castle County
8:30 a.m. to 9 p.m., St. Francis Hospital Café, 701 N. Clayton St., Wilmington
9 a.m. to noon, Porter State Service Center, 509 W 8th St., Unit 3, Wilmington
9 a.m. to 8 p.m., Brandywine Women's Health Associates, 611 W. 18th St., Wilmington
9 a.m. to 3 p.m., De La Warr State Service Center,500 Rogers Road, New Castle
9 a.m. to 3 p.m., Department of Labor, 4425 N. Market St., Wilmington
9 a.m. to 3 p.m., Northeast State Service Center,1624 Jessup Road, Wilmington
9 a.m. to 4 p.m., Hudson State Service Center, 501 Ogletown Road, Newark
10 a.m. to 2 p.m., Wilmington Library, 10 E. 10th St.
10 a.m. to 2 p.m., Woodlawn Library, 2020 W. Ninth St., Wilmington
10 a.m. to 5 p.m., Claymont Library, 400 Lenape Way
6-7 p.m., Dead Presidents Bar, 618 N. Union St., Wilmington
Kent County
9 a.m. to 4 p.m., Smyrna State Service Center
10 a.m. to 2 p.m., CHAP office, Dover
10 a.m. to 2 p.m., First State CAA, Blue Hen Corporate Center, 655 S. Bay Road, Suite 4J, Dover
1-4 p.m., Kent County Public Library, 497 Red Haven Lane, Dover
Sussex County
8 a.m. to 4 p.m., Department of Labor, 600 N. Dupont Highway, Georgetown
SATURDAY
New Castle County
9 a.m. to noon, Westside Family Healthcare, 1802 W. Fourth St., Wilmington
9 a.m. to noon, Westside Family Healthcare, 404 Fox Hunt Drive, Bear
10 a.m. to 2 p.m., Wilmington Library, 10 E. 10th St.
10 a.m. to 1 p.m., Brandywine Women's Health Associates, 611 W. 18th St., Wilmington
11 a.m. to 3 p.m., Delaware City Library, 250 Fifth St.
11 a.m. to 4 p.m., "Building Delaware" 2014 Career and Job Fair, Sussex Academy, 21150 Airport Road, Georgetown
11 a.m. to 3 p.m., Newark Free Library, 750 Library Ave.
11:30 a.m. to 4 p.m., North Wilmington Library, 3400 N. Market St.
1-9 p.m., St. Francis Hospital Emergency Dept., 701 N. Clayton St., Wilmington
Kent County
Noon to 4 p.m., Multicultural Church and Community Center, 105 N.E. Front St., Milford
Sussex County
9:30 a.m. to 4:30 p.m., Holistic Health Fair, Cape Henlopen High School, 1250 Kings Highway, Lewes
11 a.m. to 4 p.m. Building Delaware 2014 Career and Job Fair, Sussex Academy, 21150 Airport Road, Georgetown
Noon to 4 p.m., Women's Expo, Rehoboth Beach Convention Center, Rehoboth Beach
SUNDAY
New Castle County
7 a.m. to 1 p.m., Episcopal Church of Saints Andrew and Matthew, 719 Shipley St., Wilmington
1-5 p.m., Woodlawn Library, 2020 W. Ninth St., Wilmington
1-9 p.m., St. Francis Hospital Emergency Department, 701 N. Clayton St., Wilmington
Kent County
1:30-4:30 p.m., Dover Library, 35 E. Loockerman St.
Sussex County
9 a.m. to 2 p.m., Delmarva Foundation for Medical Care, 528 E. Market St., second floor, Georgetown
MONDAY
New Castle County
8:30 a.m. to midnight, St. Francis Hospital Café, 701 N. Clayton St., Wilmington
9 a.m. to noon, Hudson State Service Center, 501 Ogletown Road, Newark
9 a.m. to 3 p.m., Porter State Service Center, 509 W. Eighth St., Unit 3, Wilmington
9 a.m. to 3 p.m., DeLaWarr State Service Center, 500 Rogers Road, New Castle
9 a.m. to 3 p.m., Department of Labor, 4425 N. Market St., Wilmington
9 a.m. to 4 p.m., Northeast State Service Center, 1624 Jessup Road, Wilmington
9 a.m. to 8 p.m., Brandywine Women's Health Associates, 611 W. 18th St., Wilmington
11 a.m. to 5:30 p.m., North Wilmington Library, 3400 N. Market St.
Noon to 5 p.m., Brandywine Hundred Library, 1300 Foulk Road, Wilmington
1-7 p.m., Wilmington Library, 10 E. 10th St.
4-7 p.m., Westside Family Healthcare, 404 Fox Hunt Drive, Bear
4-7 p.m., Westside Family Healthcare, 1802 W. Fourth St., Wilmington
Kent County
8 a.m. to 4 p.m., Department of Labor, 1114 S. du Pont Highway, Dover
9 a.m. to 4 p.m., Smyrna State Service Center
10 a.m. to 2 p.m., CHAP office, Dover
Sussex County
8 a.m. to 4 p.m., Laurel State Service Center, 31039 N. Poplar St.
8 a.m. to 4 p.m., Department of Labor, 600 N. du Pont Highway, Georgetown
2-4 p.m., Milford Public Library, 11 S.E. Front St.
Tips for enrollment
• If you haven't started yet – start now
• Gather information you'll need on each person who will be included in your application – birthdates, Social Security numbers, resident document numbers
• Go to www.healthcare.gov (it is available 24 hours/seven days a week). Those who speak Spanish may use www.cuidadodesalud.gov. Or you may call (800) 318-2596 to speak with a trained representative for enrollment assistance. You can find help locally by visiting www.choosehealthde.com or www.localhelp.healthcare.gov.
• Think about what you can afford and what is most important to you – lower monthly costs (premiums)? Higher monthly costs and lower deductibles (what you'll pay up front when you receive care)? Access to a specific doctor or provider? Coverage for certain medicines? Thinking about that will make it easier to decide which plan you want when you are enrolling.
• Pay your first premium. Your coverage will begin May 1.
Source: Delaware Department of Health & Social Services, U.S. Centers for Medicaid And Medicare