NEW YORK - While it has enrolled a half a million New Yorkers through the Affordable Care Act, New York has not done a good job of reaching out to Latinos, Hispanics and immigrants, according to Jackie Vimo of the New York Immigration Coalition. Just look at the state health care exchange website, she said - if you can read English.
"It is a little bit mind-boggling that New York did not consider it a priority to translate the web site, given that we have a law that requires vital documents to be translated," Vimo said.
The actual application is only available in English. Operators said translations are in the works, and Spanish-speaking operators are available by phone.
When it comes to health care, New York is among the five states with the greatest number of eligible uninsured Latinos, an estimated 500,000. Nationwide, 32 percent of Latinos are uninsured, compared to 16 percent of non-Latinos.
According to U.S. Census data, a large majority of Latinos in the U.S. are English-dominant, and 63 percent were born in this country. The longer people reside in the U.S., the more likely they are to have health insurance.
Vimo said the state has not released any demographic information about people who have obtained insurance.
"In New York, we don't even have data on how many Latinos or other immigrants have signed up for the exchange. The New York Immigration Coalition has recently submitted a Freedom of Information Law request asking for that data," she said.
With just days to get an application in during this first open-enrollment period, Mayra Alvarez with the U.S. Department of Health and Human Services said there are a myriad of options.
"They can do it in person in their community with someone they trust. They can do it online at HealthCare.gov. They can do it via phone at 1-800-318-2596. They can even do it during a paper application. Please don't pass this opportunity up," Alvarez explained.
The deadline to enroll in a marketplace plan for this year is one week from today, on March 31. Those who do not sign up for health coverage could face penalties.
Vimo said her group is exploring ways to push for exceptions under the law for those who were challenged in meeting next Monday's deadline.
Individuals may be exempted from the requirement to buy insurance if they file a form and qualify (for example, if their previous plan was terminated and no affordable alternative plan is available). If they think insurance is unaffordable based on their projected income, they may be allowed to buy a policy for catastrophic coverage only. Information about exemptions is available at www.healthcare.gov/exemptions/.
Enrollment is available by calling 800-318-2596 or visiting www.HealthCare.gov (English) or www.CuidadoDeSalud.gov (Spanish).
This story was produced with data and editorial assistance from NewsTaco, www.newstaco.com/.
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A recent report examined how some rural Tennessee hospitals have managed to stay afloat despite financial challenges.
The report includes interviews from staff at five different rural hospitals, which range in size from 25 to 125 beds.
Judy Roitman, executive director of the Tennessee Health Care Campaign, said some of the hospitals are drowning in uncompensated care. She explained as part of their research, they did an interview with a CEO from a rural hospital in Kentucky who expressed the importance of Medicaid expansion.
"Kentucky has expanded its Medicaid program and Tennessee has not," Roitman pointed out. "He said that's the key to our stability is actually having the funds coming in to treat these patients. And the CEOs and others in Tennessee hospitals said it would make a huge difference to have that federal funding."
Roitman added the federal government is offering Tennessee a nine-to-one match. If Tennessee were to expand Medicaid, at least 330,000 people would gain access to coverage.
Roitman pointed out the report suggested further steps hospitals could take, including examining how they are reimbursed for services provided. She noted private insurance plans tend to provide the highest reimbursement rates, and said more funding is needed to support TennCare, which does not cover enough of the cost.
"TennCare is all managed by managed-care organizations," Roitman explained. "They negotiate with every hospital about how they're going to reimburse and the big hospitals have some leverage to demand better payment and the smaller hospitals are just, they're just not getting paid."
Roitman added the report credited strong community engagement and effective hospital leadership as key factors in staff retention. Robust management and maintaining an engaged workforce significantly affect a hospital's viability, according to the report.
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Medicare and Medicaid are key sources of health coverage for many Americans and some people qualify for assistance under both programs. With lagging enrollment for the unique plans, outreach efforts are underway.
According to KFF Health News, only about three in 10 people who qualify for Dual-Eligible Special Needs Plans were enrolled in 2021. Experts said the option is designed for people who need additional help because of disabilities, certain health conditions or their age.
Dr. Gina Williams, associate medical director for UnitedHealthcare, said the plans try to take a dynamic approach to serving those eligible.
"Everything from managing your wellness to managing your behavioral health needs and then everyday needs," Williams outlined. "It's kind of a more comprehensive package for people who need a little bit more support."
Everyday needs include meal benefits and bathroom safety devices. The National Council on Aging said D-SNPs aim to provide a more streamlined coordination of care because there is assistance in arranging the services. Wisconsin's enrollment numbers are similar to the national rate, at 28%.
Christine Huberty, lead benefit specialist and northern region supervising attorney for the Greater Wisconsin Agency on Aging Resources, said a tricky component of the plans is navigating provider network restrictions. A rural resident might have to travel farther to see a doctor covered under the plan and she cautioned it warrants careful research when enrolling.
"I would say first and foremost, look at the provider network restrictions," Huberty advised. "Look at what's available in your area."
Meanwhile, Williams noted the push to get more eligible people to sign up coincides with more awareness around preventive care in a post-pandemic world.
"Everybody's kind of going into a phase where they're not only thinking about acute illness, but they're thinking about overall care," Williams observed. "What was the impact of the pandemic from a psychological standpoint? Do you need more support and then you also need more coordination of benefits?"
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In Mississippi and across the country, Community Health Centers are getting a funding increase, thanks to Congress passing a bipartisan spending package.
Community Health Centers in Mississippi serve patients without regard to their insurance status or ability to pay. More than 20 locations in the state provide medical care to more than more than 380,000 people.
Joe Dunn, senior vice president of public policy and advocacy for the National Association of Community Health Centers, said roughly one in 11 Americans gets their care from this type of clinic.
"Community Health Centers are the largest primary care network in the nation, providing care for 31 million Americans," Dunn pointed out. "This network is critically important, because they provide primary care, behavioral health, dental; just an array of services that are so critically needed."
Dunn emphasized more can be done. Research shows more than 100 million Americans need better access to primary care. Community Health Centers in Mississippi also support more than 4,000 jobs and about $678 million dollars in economic activity in the communities where they're located.
Dunn noted the increased funding from Congress will help the clinics provide more comprehensive care and reach more underserved patients, especially in rural communities, which ends up saving the state money.
"By incentivizing people to go get primary care, you alleviate more downstream costs," Dunn emphasized. "There's fewer hospitalizations and complications from chronic conditions, based on preventive screening and care at the outset."
The Congressional Budget Office reports the increase in funding for Community Health Centers just through the end of this year will reduce federal spending on public health insurance programs by more than $700 million.
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