Promotoras spread the word about enrolling in health plans

HOLLYWOOD >> Helicopters roared above. Trucks rumbled by. Dark clouds threatened rain.

The world around Victoria Mercel seemed to be against her on a recent morning as she prepared to speak about health care insurance to a group of day laborers near Sunset Boulevard.

But for Mercel, a mother of five who lives in Los Angeles, the noise and cold were small inconveniences. Her greatest challenge was to convince the dozen men and women bundled in hoodies and hungry for work, that even if they don’t qualify for health insurance under Obamacare, they play an important role.

“Even if they don’t qualify, they will take the information to someone else,” Mercel said with hope, before she handed out pamphlets and fliers in Spanish.

“Maybe they know a child in need, who qualifies,” she said.

As a promotora or health promoter, Mercel’s goal is to spread the word in the Latino community about enrolling in health care plans as mandated by the Affordable Care Act. Her work is especially critical as a new deadline to sign up approaches in March, and policy makers have found that enrollment is lagging among Latinos, who make up about 60 percent of all uninsured individuals in California.

And so Mercel goes where she believes her message will be heard: to libraries and community meetings, school auditoriums and Los Angeles’ fashion district at 9th and Santee streets and inside every other nook and cranny of the region where Latinos work, meet and talk. She even attended a naturalization ceremony at the Los Angeles Convention Center Wednesday morning, where she planned to speak to newly sworn in U.S. Citizens.

“Even if I have to meet under a tree, where there’s no air conditioning and no where to sit, I’ll talk to people,” Mercel said.

Once known as an informal group of volunteers who passed on health advice on everything from preventing heart disease or diabetes, to talking about breast cancer in their neighborhoods, promotoras are now formally trained.

Mercel works for Vision y Compromiso, an organization formed in 2000 that trains promotoras on how to conduct outreach and education programs based on health issues. In May, Vision y Compromiso was one of 48 organizations named by Covered California to receive part of $37 million in grants to conduct outreach.

Mercel is one of two promotoras whose beat includes Los Angeles, and she is one of 20 statewide with the organization.

“Our promotoras are out in the trenches,” said Rosa Olaiz, lead promotora for Vision y Compromiso’s Covered California program.

“Most people are very welcoming, especially when we go to the schools, because many will ask how to enroll their children,” Olaiz said.

But the challenge for many of the promotoras is to untangle a knot of misinformation that seems to have left Latinos afraid to enroll.

“One of the things many of us have been told is people are afraid they are going to have to pay a lot of money,” Olaiz said. “One of the things they find out is they may have government assistance. Once they get the information, they can’t believe it. We’re really working hard to get the word out.”

SPECIAL EFFORT TO REACH LATINOS

Back in December, officials with Covered California acknowledged their slow start in reaching out to the Latino community. For one, the Spanish-language paper applications weren’t immediately available. There also was a lack of Spanish speaking enrollment counselors. Of the half a million people who enrolled in the first three months since Covered California began accepting applications, 13 percent identified themselves as Hispanic. By Covered California’s estimates, at least half of the 2.2 million uninsured California are Latinos who qualify for government subsidized coverage.

As a result, Peter Lee, the executive director of Covered California announced on Monday that of the 350 new people hired to operate the call centers, 30 speak Spanish.

California state Sen. Ed Herandez, D-West Covina, who leads the Senate Committee on Health has said he was concerned about Covered California’s efforts. He said messages are getting through, and momentum is building but the state needs to focus on helping people enroll, to understand that there is diversity within the Latino community. Not all speak Spanish, he said. And those who are not legal residents can buy insurance, they just don’t qualify for the government subsidies.

Still, Hernandez said California’s enrollment is much better than the federally run exchanges. Federal figures show that more than 700,000 Californian’s have enrolled, about a fourth of all those signed up across the nation.

“Her work is not in vain,” Hernandez said of Mercel. “California is doing much better than the rest of the nation. There are problems, but they are fixable. California has led the nation.”

On the morning Mercel made her presentation, she competed with street noise and the cold, as well as a reality about the Affordable Care Act that had set in among the day laborers. But she continued, even if they looked let down or frustrated and even as some walked away. She explained how health plans are broken down into the bronze, silver, gold and platinum tiers, how those who qualify for plans must be U.S. Citizens, but if they are not, can still go to community clinics for care. And she warned them not to trust anyone who charges for enrollment services.

“If they let me, I would pay for it,” said one man named Miguel, 38. “By telling us we can’t pay for insurance, that we’re not included, is like saying we’re not humans.”

Another man with paint splattered across his jeans and jacket agreed, saying people on the street talk about how they soon won’t be allowed to use community clinics.

“Everyone here is a person, a human being who has value,” said the man, who identified himself as Gustavo. “We would be a part of (Obamacare) if they let us.”

Mercel said her motivation to reach everyone with information comes from a desire to make people understand the importance of remaining healthy.

“I worry for all my people,” Mercel said. “A promotora doesn’t just educate the community, she understands them, is conscious of their needs and issues. I want them to know it’s good to have coverage, that they need to maintain good health so they can live a good life."