Health Care
11:09 am
Fri January 17, 2014

Is The Obamacare Website Not Spanish Friendly?

Originally published on Fri January 17, 2014 11:56 am

Transcript

MICHEL MARTIN, HOST:

This is TELL ME MORE from NPR News. I'm Michel Martin. Later this hour, we are going to head to Nigeria where a new law intended to discourage homosexuality is already leading to arrests of LGBT citizens. It is also widely popular with other citizens. We'll hear more about that later. But first, we want to talk about the new healthcare law in this country, the Affordable Care Act. You've probably heard about all the challenges people have had signing up for coverage under the law - website problems, confusion over plans and policies. I'm sure that sounds familiar.

But new reports say those challenges have been especially difficult for Spanish speakers to overcome. And getting that group to sign up could be a big key to the program's success. We wanted to talk more about this so we've called Daniela Hernandez. She is a reporter for Kaiser Health News. She's with us from Stanford, California. Welcome, Daniela. Thanks so much for joining us.

DANIELA HERNANDEZ: Hi, thank you for having me.

MARTIN: Also joining us is Laura Martinez. She is a senior editor of CNET in Espanol. She writes about Spanish-language marketing on her blog, "Mi blog es tu blog." And she's with us once again from our studios in New York City. Laura, welcome back. Thanks for joining us once again.

LAURA MARTINEZ: Gracias, Michel. Thanks for having me.

MARTIN: So, Daniela, let me start with you. You write that many people who speak primarily Spanish missed the December deadline for health insurance plans beginning January 1. How big of a group are we talking about? And was there one big reason that caused them to miss that deadline?

HERNANDEZ: Well, so there's about 3.7 million people - Latinos who rely primarily on Spanish. And, you know, a good chunk didn't make the deadline including, actually, my own parents. And the reasons for it - I mean, primarily, I think it had to do with a lack of access to information and people to help this population sign up for care, you know. A lot of the stuff now happens on computers, and a great majority of this population doesn't have access or isn't comfortable with it.

So they feel more comfortable going to, you know, trusted people, like in community centers or clinics, that could help them sign up, but because the process takes a long time, you know, there's only so many people that they could help at a single time.

MARTIN: So what I'm hearing from you is that it's primarily the way that this community was approached as opposed to a technical problem. But we're also hearing that there were technical problems, that the Spanish-language website was a mess. And there are conflicting reports about that. Daniela, can you tell us what's your perception of that?

HERNANDEZ: Sure. Well, I mean, the website itself, cuidadoesalud.gov, didn't launch. Like, you couldn't sign up for care through that website until, you know, two months after the fact. So, yeah, there were definitely problems with that. One of the things that came up was that - so, you know, when you go on to cuidadodesalud.gov, for a long time, also, like, that first module where you could go on and look for plans and kind of window shop - compare and contrast, you know, whether plan A was better for me or plan B or, you know, plan C, like, that part was not available in Spanish. So until recently, when you went on the website, it would say something like, you know, information for plans and then it would have in parentheses "In English" and that would take you to an English language website. So people couldn't really assess whether, you know, different plans would fit their needs in Spanish and that was a big problem.

MARTIN: So they couldn't even really access all the information in their language of choice?

HERNANDEZ: Correct. I mean...

MARTIN: So let me hear from Laura for a minute. So, Laura, as somebody who writes about Spanish-language marketing and also technology, what are you hearing about this?

MARTINEZ: OK, first of all, Michel - and thanks for the opportunity - I really wanted to address one particular article. And this is an AP article that was reproduced in a lot of newspapers. I actually saw this story first in the Washington Post. It was a story talking about how the Spanish language page of Obamacare was riddled with mistakes. They used that phrase. They even criticized the name of the page, cuidado de salud, as being wrong. This is not true. I was appalled to see that AP would have so many things so wrong in that article. So I would like to start...

MARTIN: So tell me what you think is true. In terms of why...

MARTINEZ: OK, in terms - OK, first of all, there was a couple of things - first of all, when I saw the headline, and the was hilarious, it was like, oh, my God, this comes from like my blog. The headline was Obamacare's website isn't in Spanish, it's in Spanglish. First of all, it's not in Spanglish. Daniela, said something that is true, though. When I went just out of curiosity to try to sign up for a plan - I am a resident of New York so when I found the module for New York and I clicked on it, it very specifically tells me you are going to be redirected to the I think it's called New York State Health and that page is only available in English.

So that is true that some of the pages still, like, today are unavailable, but I think this is a bigger problem than just the cuidado de salud. Another problem I had with the AP report was that at some point, they were saying that the word prima, which is Spanish for premium, was incorrect because it's a female cousin. I mean, everybody knows that prima, it's true - it's your prima - your female cousin, but it's also prima de salud and that is perfectly fine Spanish. I had issue with it.

MARTIN: Yeah, I sense that this is a big issue and the fact that this has been a very big debate among the people who speak Spanish or write - or who are bilingual who write in both Spanish and English. It's interesting, we've heard from a number of commentators about them really taking issue with this report.

MARTINEZ: Yeah.

MARTIN: And I appreciate that, but we don't have somebody from the AP to give their perspective on it.

MARTINEZ: Sure.

MARTIN: So can I just ask you sort of more broadly - and Daniela made two points - she made - there was one, there's a technical issue and she also made the argument that the way the community was reached out to, that many people would prefer to have a person to work with to kind of walk through. Do you - does that jive with what you think as well?

MARTINEZ: I totally agree. I totally agree. I mean, I see it all the time. I mean, we at CNET in Espanol, we have a lot of information and stories about technology, but it's true that the big majority and, especially I think - I mean, I don't have the data in front of me, but I'm sure that recent immigrants or Spanish-dominant immigrants, they tend to have less access to technology or at least they are not as savvy as, let's say, maybe the ones that were born here or the younger ones.

But what I would like to also add is that I think it would be irresponsible to also say or assert that the lack of signing up and enrollment among Latinos had to do with glitches specifically of the language of the site. I do agree with Daniela that this is - a friend of mine put it beautifully. She said something like, this is like trying to present a beautiful product in total darkness. And this darkness has to do with a lack of proper information in language, in Spanish and in person to a lot of people who have no idea what this whole Affordable Care Act is all about.

MARTIN: If you're just joining us, we're talking about Obamacare, the Affordable Care Act. And we're talking about the particular challenges that Spanish speakers have faced trying to participate in the program. We're speaking with Laura Martinez of CNET in Espanol. That's who was speaking just now. Also with us Daniela Martinez of Kaiser Health News. So, Daniela, I'd like to ask you why does it matter both for the mission of the program and the financing of the program? I mean, you said that this is about 3.7 million Latinos who are Spanish primary. Is it a big problem for the program if this community does not find their way to it?

HERNANDEZ: Well, I mean, it's been said many times that's Latinos are a crucial part - a crucial point for the success of this program. And partly it's because, you know, a lot of them skew younger and they're healthier. I don't know what the stats are in terms of, you know, this particular population that we're talking about - this 3.7 - how healthy they are or how young, if they fit into that category. But it is a great majority of the population, and it's a population that definitely needs care. And, you know, just in general, like, this - Latinos are really important politically as well. So, I mean, I think the ramifications go beyond just the law.

MARTIN: Laura, what do you think about that? I mean...

MARTINEZ: I wanted to make - yeah, I wanted to make a point about that. I have a personal friend - a very close friend, she lost her steady job. I mean, she's a Latina. She's bilingual. She's a professional. She lost her job and now she's just freelancing. She took on a lot of projects. So she went into the website and mind you, this is someone who is fully bilingual so she didn't even go to the Spanish site. She went to the English site.

And turns out that she was too poor for certain things, but too rich to actually sign up for the plan. So I think a lot of Latinos and non- Latinos even are sort of, like, stuck in this gray area in which they, you know - they do not to meet the requirements to sign up. And, also, another point I wanted to make, at least for, again, recent immigrants or older Hispanics, we don't come from countries where health care is really a priority, and everybody is covered. I mean, in Mexico, for example, I can tell you 90 percent of my family are uncovered because you either have to be very rich to buy a private healthcare. So there is a lot of - there is not enough of information, and there is really not a culture of understanding and really embracing the importance of having insurance especially in a country like the U.S.

MARTIN: I see.

MARTINEZ: ...That we know if you don't have insurance, you're pretty much...

MARTIN: Pretty - it's interesting...

MARTINEZ: ...In trouble.

MARTIN: I see, well, those are helpful insights. So Daniela, a final question. We only have about 50 seconds left. What steps is the administration taking to address these problems if any?

HERNANDEZ: Well, they've said that they're upping the number of people who they're going to have on the ground so these navigators that are going to be helping these communities sign up in person, in trusted settings like libraries and community clinics. So just more of that in-person, one-on-one interaction with somebody that they trust like we were talking about before. There's going to be, you know, sign-up fairs around in campuses, again, in community clinics, just more information so that people have that available. I think they're also upping some of the - the number of bilingual translators - or bilingual people at call centers...

MARTIN: OK.

HERNANDEZ: ...So that when people call, like...

MARTIN: OK.

HERNANDEZ: ...They don't get no answer.

MARTIN: All right. Well, thank you for keeping us up-to-date. Do keep us posted on this. Daniela Hernandez is a reporter for Kaiser Health News. Laura Martinez blogs at "Mi blog es tu blog." And she's also senior editor of CNET in Espanol. Thank you both so much for joining us. Transcript provided by NPR, Copyright NPR.