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Obamacare enrollment reopens; language still a barrier

Health care “navigators” in Arizona said they learned a lot during last year’s bumpy rollout of Obamacare and are ready to apply lessons learned to the second round of open enrollment that kicked off Saturday.

Chief among those lessons: You’ve got to speak the language.

“It is a huge frustration. We know how many different language communities there are,” said Zeenat Hasan, director of empowerment and advocacy at Asian Pacific Community in Action in Phoenix.

While the Affordable Care Act website is available in English and Spanish, Hasan said her agency alone encountered languages ranging from Vietnamese to Mandarin Chinese to Punjabi last year in the initial enrollment period. This year, as last, her office will have interpreters, navigators and certified application counselors who can communicate with would-be applicants in 31 different languages.

Language is just one of the challenges navigators are bracing for, along with reaching out to underserved minority communities, verifying immigrant status – and just explaining the maze of health insurance to people who may never have encountered it before.

And navigators think they are prepared, touting new strategies this year to reach underserved communities throughout Arizona that include more language readiness, new partnerships to help reach those overlooked communities and more outreach events with those partners.

“It is about recognizing community need and being proactive,” said Cheryl O’Donnell, Arizona director of Enroll America.

Groups like hers and Hasan’s, informally known as navigators, help people and businesses find health plans under the Affordable Care Act, or Obamacare, either through the insurance marketplace or through Medicaid.

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The program started last year with a much-hyped, and troubled, six-month enrollment period. People who enrolled then can shop for a new plan under the three-month open enrollment period that starts Saturday, or those who did not enroll can get insurance for the first time.

Navigators in Arizona said they are focused on reaching those uninsured people who did not sign up last year.

Hasan said her organization aims to help people “who have never had health insurance in their lives,” often those who live in areas where English is not the dominant language and where there are many foreign-born residents.

O’Donnell agreed there is need in those pockets of the state where many refugees have come to resettle – mostly in Phoenix and Tucson.

“Minorities are the most underserved,” which O’Donnell thinks is a “reflection of how information gets to those communities.”

Hasan said it can be hard enough for English-speakers in the state to get information about health coverage, much less non-English speakers.

“You don’t see billboards in Arizona about the Affordable Care Act and you don’t see a lot of campaigns,” she said. “You just don’t see that kind of environment.”

O’Donnell said she recognizes a lack of education on Obamacare in the state. New partnerships and more community-driven outreach have been geared to confront the issue in the upcoming enrollment period, she said.

“With new partnerships, the intent really was to expand the availability of service in a language other than English,” O’Donnell said. “When someone comes in, they are able to identify what language they speak and help them in their language.”

Hasan said that while strides have been made, challenges remain, such as the online application being available only in English and Spanish.

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Another challenge last year that she expects to see in this enrollment period is the difficulty in verifying the immigration status of applicants, she said.

“The problems that we encountered within families were primarily verifying their legal status,” Hasan said.

While it usually took a couple of hours to find a health insurance plan for a family of four last year, Hasan said that families where immigrant status was an issue might have had to come back multiple times, greatly adding to the application time.

Time is especially important in this second open enrollment period, which is only half as long as the first go-round. The open enrollment period that starts Saturday ends on Feb. 15.

Hasan said her organization has a goal of enrolling an additional 2,000 people this year in Obamacare or Medicaid, the insurance option for low-income residents. One way to do that is by reaching the “gap communities,” she said, those that others may not even realize they are missing.

“We know the communities and we know who we are serving,” Hasan said.

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Healthcare.gov is the gateway for applying for insurance coverage under the Affordable Care Act, better known as Obamacare. The second open enrollment period for coverage under the act runs Nov.15-Feb. 15.

Speak easy

The Census Bureau looked at a multiyear period, 2008-2012, and came up with the following estimates of English proficiency of Arizona residents during that period:

Total Arizona Population:

  • 90 percent spoke English very well
  • 10 percent spoke English less than very well

In other language groups, the percent who spoke English less than very well was:

  • 43 percent among Asian or Pacific Island language speakers;
  • 39 percent among Spanish speakers;
  • 24 percent among speakers of other Indo-European languages;
  • 27 percent among speakers of all other languages.