Edgar Aguilar, program manager with Community Health Initiative, a network of grass-roots organizations in California that assist people signing up for insurance, said even though California does not face some of the same challenges as states using the federal marketplace, enrollment this year will be challenging.
He is in charge of the operation in Kern County, in the Central Valley, which has a high population of Latino farmers.
"We were successful signing up Latinos in the past, there are less than 8 percent of Latinos without insurance in the county, but the confusion about what is happening with Obamacare and the fear of immigration problems make people think twice before renewing a health plan or (signing) up their kids for Medicaid or CHIP", he said.
Navigators surveyed for this article said they feel more tension this year in the days leading up to the start of enrollment.
Hispanic members of Congress sent a letter to the Department of Health and Human Services in August seeking reassurance that enrollment outreach would continue for Latinos. A spokesperson for the caucus said an HHS representative promised to set up a meeting on the issue, but it never happened.
One hurdle to enrollment is the fear of deportations. Undocumented immigrants do not have the right to buy health insurance through the ACA markets, but there are thousands of families with mixed immigration status, and advocates fear they may be hesitant to buy insurance or apply for subsidies to help pay for coverage.
"Since the new government took office, when raids increased and the legal status of 'Dreamers' (young people brought to the U.S. illegally while children) was in jeopardy, people started canceling their appointments with the navigators, and stopped enrolling their children in Medicaid or CHIP," Bouton said.
However, navigators said they aren't giving up. "We keep making calls. We have the same goal of registering more people," said Maldonado. Her organization is operating with a 30 percent lower budget for navigators. In her state, Cover Arizona, a network of nonprofit organizations, continues to organize events, hand out leaflets and make calls to encourage enrollment.
"We had to cut the budget for marketing, but another organization that did not have that cut helps us and distributes our brochures," Bouton said. More than ever, navigators say, the focus is on teamwork.
"We are passionate about what we do, and we will try to enroll as many people as possible," said Holloway.
(Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.)
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