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Enrollment Targets Uninsured Hispanics

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CuidadodeSalud.gov

Luis Alejandro Larrorte has lived the past two decades in the United States -- all of it without health insurance.

But the 56-year-old who sells cable satellite plans as a contractor was diagnosed with eye cancer. And the Pembroke Pines resident was eager to sign up on the federal healthcare marketplace.

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Luis Alejandro Larrorte of Pembroke Pines

But the Colombian native - who now is a U.S. citizen - says a lot of the insurance and medical terms involved didn't translate well into the Spanish-language website.

“It was impossible for me, really, really impossible, because there were so many problems, confusion, the computer not working,” he said. "And it was for me very bad because I need some medical treatments for my eye.”

This year, Larrorte met application navigators from the Epilepsy Foundation of Florida in person, and found a comprehensive plan he can afford with his $22,000-a-year salary.

Speaking to someone in person helped him understand how, starting Jan. 1, his monthly premium will be $110 a month, and his out-of-pocket deductible is $2,000. It’s a lot of money, but he understands well enough he can navigate his health care now, he said.

“I am happy because I got some coverage yes – I am very, very happy. I am very enthusiastic about that. My situation, my real situation for me (now) is that I need to pay, I need to work so hard to try to pay for the deductions,” he said. “My treatment is nothing easy. And It’s going to be expensive.”

  Hispanic Floridians like Larrorte are a major focus of the second year of enrollment on HealthCare.gov. Census figures show that 30 percent of Latinos in the state don't have health insurance.

But last year's attempts to enroll many in the Hispanic community failed to convince many to sign up, although the federal marketplace offered subsidies on monthly premiums for low- and middle-income individuals and families.

"Some of the people they are trying to reach are people that have had no insurance in their entire adulthood,” said Josephine Mercado, director of Central Florida’s Hispanic Health Initiative. “And those few that did were because the employer provided the insurance. So they never had to make any of these decisions about what kind of insurance would be best for them until now.”

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Josephine Mercado, founder and director of Central Florida's Hispanic Health Initiatives

Enrollment is difficult for a population unfamiliar with the terminology surrounding the Affordable Care Act and health insurance, Mercado said. Final enrollment numbers for 2014 show that just 20 percent of those signing up on the federal insurance marketplace identified as Hispanic.

"So now you have a very complicated law, and you also have to learn the insurance system at the same time. So as a result, some people actually froze. They did go in. It’s not that they didn’t try,” Mercado said. “They found problems they could not overcome. And as a result they did not sign up.”

Groups hired to serve as enrollment navigators a year ago learned a lot of lessons from 2014, said Judy Clauser, director of special projects at the Epilepsy Foundation. Her group is one of three helping Floridians with the 2015 enrollment period that ends Feb. 15.

“We’re basically trying to work with groups that have already earned a reputation and gained the trust of the Hispanic community,” said Clauser, who is based in Miami.

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Judy Clauser, director of special projects at the Epilepsy Foundation of Florida

Mercado said she has seen a lot of improvement in year two. Most important, she says, is that the trained navigators from groups like the Epilepsy Foundation are out in Hispanic communities, at churches, libraries and the like.

"They are scheduled for regular days at different community organizations as well as churches. And the church is a great place to do enrollment, because for Latinos and other groups, many will see that as a seal of approval,” she said. “They’re doing this in my church. Then it must be good."

The navigators also are much better at helping people understand the details of the private insurance plans offered through the federal exchange, Clauser said. While a lot of attention is paid to how much a person will pay for their insurance, navigators are focusing on matching the services offered in a plan with a person’s real health needs.

“One of the lessons learned from the first enrollment period was to really impress the importance to the consumer of not just selecting the least expensive plan. But better to choose the plan that best meets their needs,” she said.

Also, bilingual navigators are a mainstay at most insurance enrollment events across Florida, like a recent one at the University of South Florida student union in Tampa. Michelle Schaefer said she and other navigators are trained to guide consumers through the Spanish-language enrollment site, CuidadodeSalud.gov

“What takes up the most time is choosing a plan. It's the most important part,” she said. “And we don't let consumers just pick any plan, we have to call the doctors, if they have doctors that they already see.”

Schaefer - a navigator for Florida Covering Kids & Families - says all consumers need the confidence to ask questions and then get the answers they need in a language that connects.

"Ask questions! If you don't know whether you're eligible, if you have questions on how the law works, what's the eligibility? How much of a subsidy will I get?” she said. “Come! And we'll show them and walk them through all the steps until the end."

About 200,000 Floridians are expected to sign up for insurance on HealthCare.gov for 2015 – adding to the nearly 1 million who enrolled in the first year of the health care marketplace.

Mercado says it may include a lot of Hispanic legal residents who last year were scared by rumors that getting health insurance could affect the immigration status of an enrollee or one of a relative.

"Among those people that stepped back and did not (enroll) are those who had immigration questions in the back of their minds,” Mercado said. “And now they will hear of other stories from people that had immigration questions similar to theirs and everything worked out. So they will be encouraged to apply also now."

Larrorte - the Pembroke Pines resident - says Latinos scared off last year should give enrollment another try. If the website doesn’t work for you, go see someone in person, he said.

"I try many times in Spanish to try and get some information in the plan or in the coverage. But it was so difficult, that is the reason you need to try find a person who can tell you, or go and try to speak in English."

--WUSF Reporter Yoselis Ramos contributed to this report.

Health News Florida Editor Mary Shedden is part of WUSF Public Media in Tampa. She can be reached at (813) 974-8636, on Twitter @MaryShedden, or at shedden@wusf.org. Health News Florida receives support from the Corporation for Public Broadcasting.