Immigration Status Adds Layer of Complexity to ACA Enrollment

One NCLR Affiliate is working to reach eligible immigrants in families with mixed statuses

By David Castillo, New Media Manager, NCLR

The promise of the Affordable Care Act (ACA) can only be met once everyone who is eligible and in need of health coverage receives it. This is especially true for the Latino community, which stands to benefit the most from the new health care law, but only if more of us enroll.

For millions of Americans navigating the Health Insurance Marketplace, there are myriad questions ranging from what plans make the best fit to how much coverage is needed. These are basic questions anyone might have, but for many families, questions about immigration status can complicate the process, especially for those in mixed-status families who are eligible for coverage under the ACA.

A CPLC staffer assists a Tucson resident in signing up for health coverage.

A CPLC staffer assists a Tucson resident in signing up for health coverage.

Mixed-status families, defined as those with members who have different immigration statuses in the same household, often face some of the biggest obstacles to getting coverage for their eligible members. It is a population that requires special consideration for their family dynamics and their cultural sensitivities. One group that has been working closely with this population is Chicanos Por la Causa (CPLC), an NCLR Affiliate based in Phoenix.

As brokers for insurance company Blue Cross/Blue Shield, CPLC is involved in going into the community to answer questions, address concerns, and get people signed up for health coverage. CPLC Insurance President Alicia Nuñez and Lead Sales Representative Rosa Castillo have a lot of experience working with mixed-status families and spoke with us about the challenges they encounter in enrolling folks.

“The overwhelming concern people have is about enforcement of immigration laws,” said Nuñez. “Most of the questions we get are ‘will this affect my status?’”

Nuñez and Castillo drive home the point that information is not collected for immigration enforcement purposes. It’s one they have to stress often. Both credit the anti-immigration attitudes and policies that have become synonymous with Arizona as part of the problem. “They are often scared to even ask about health care,” said Nuñez.

Another of the concerns parents raise is related to the eligibility of their children. Undocumented parents are often unsure whether their kids even qualify. “They don’t believe the subsidies would apply to them because they [the parents] don’t have legal status,” said Nuñez.

CPLC has also done a lot of work in providing the community with a base level of understanding of what health insurance is and how it works.

“Regardless of mixed-status or not, if they’ve never had health insurance, explaining it and how it works… takes up the most time,” said Castillo. CPLC has made it a top priority to educate the community so folks have a general understanding of the ACA.

Nuñez and Castillo have resorted to some creative tactics to achieve this goal.

“A lot of folks come here because they know it’s the law. So, I’ll just draw basic pictures or diagrams that show the White House and Congress and the laws coming from them. It helps give them a basic understanding,” said Nuñez. “I find that people really like that.”


A CPLC staffer provides a demonstration at a Dia de los Muertos enrollment event.

They also use the car insurance model, which many immigrants are more familiar with, to help draw a clearer picture of how ACA works. “We try to explain it as clearly as possible, but explanations are tailored for each person that comes in. By the time folks leave, they have a good understanding of how insurance works, no matter their understanding when they walk in,” said Castillo.

CPLC’s work to enroll people has certainly paid off. Castillo shared one success story of a woman who in 2008 found herself in the hospital for just a few days. At the end of her stay, she was presented with a $78,000 medical bill.

“It stressed her out and she lost her job. She was afraid of everything,” said Castillo. “She now has affordable insurance. The beauty of having affordable health insurance in her life has enabled her to get out of her house, and has given her freedom and peace of mind.”

With little more than two weeks to go, Nuñez and Castillo know they have their work cut out for them to ensure more ACA success stories become a reality. If you’re in the Phoenix area and still need to sign up for health coverage, visit CPLC any day of the week. The NCLR Affiliate will also be holding enrollment events on February 7–8 and February 14–15, the last weekend to enroll.

We have also put together a quick list of what you need to know about getting covered if you’re in a mixed-status family. For extensive information on the Affordable Care Act, visit us at:

Community Leaders Learn How the Affordable Care Act Can Create A Better, Healthier America

By Delia Pompa, Senior Vice President, Programs, NCLR

As implementation of the Affordable Care Act (ACA) ratchets up it will continue to directly impact the health and well-being of Latino families all across the country.  Hispanics in the United States are disproportionately uninsured, with about 15.6 million lacking health coverage, but the ACA has the potential to change that.

Delia Pompa

Health care reform is strengthening consumer protections to ensure that millions more Americans will be covered under quality, affordable insurance plans, regardless of preexisting conditions.  The ACA bolsters preventive care services that are critically needed among Latinos, who often don’t have access to-or money for-the simple tests and checkups that can prevent dangerous health problems down the road.  The reform package also invests billions of dollars into community health centers throughout the nation, which serve as a critical source of health care for Latinos, both insured and uninsured.

There is no doubt that the ACA has the potential to drastically reduce and ultimately eliminate the vast health disparities that exist for Latinos in this country.  But in order for it to do so, we must make sure that community health centers and other community-based organizations understand how to take full advantage of the opportunities that the ACA provides them.

This year, at the 2013 National Council of La Raza (NCLR) Health Summit, nearly 200 national Latino health advocates, policymakers, and practitioners convened to discuss the unique challenges in health care coverage and delivery that impact the Latino community.  With implementation approaching sooner than most may think, there are still many questions surrounding the law.  Practitioners and other health professionals were eager to learn how to ensure that Latinos in their communities are informed and well-positioned to benefit from the historic legislation.

Experts in public health, nonprofit organizations, and government agencies, such as the Office of Minority Health in the U.S. Department of Health and Human Services, offered informative workshops that touched on topics including health disparities, cultural competence, and civil rights protections under the ACA.  For participants at the Summit who serve as a lifeline for hundreds of thousands of Hispanics every year, the workshops offered a chance to open a dialogue with and pick the brains of those who will be implementing the law.

Fernando Godinez, Executive Director of the Mexican American Unity Council, an NCLR Affiliate based in San Antonio, said, “As a provider of health services to a diverse, urban community, I found the Summit incredibly helpful in giving me the information, tools, and confidence to help families back home become fully engaged in the opportunities that the Affordable Care Act provides them.”

Walking away from the Summit, it’s clear that it will take a large network of community-based organizations and nonprofits like NCLR working together to ensure that no one is left out of ACA implementation, and to ensure that families are engaged with the health insurance marketplaces and other health coverage options available to them.  But it’s also clear that we have the Obama administration and other federal agencies behind us doing their best to open up access to health care to millions of Americans.  Together, we have an opportunity to use this historic law to create a better, healthier America.