"Si Se Puede!": Tips for Increasing Medicaid and CHIP Enrollment in Hispanic Communities

October 6, 2016

The uninsured rate among all U.S. children reached a historic low of 6 percent in 2014. Despite this positive trend, seen as result of the expansion in eligibility for Medicaid and the Children's Health Insurance Program (CHIP) and more effective outreach and enrollment campaigns, Hispanic children remain at least twice as likely to be uninsured compared to white children.

This disparity in uninsured rates of Hispanic families and children is due to a number of enrollment barriers and challenges. Organizations and individuals helping to enroll Hispanic families in health coverage have emphasized the following barriers to their outreach efforts: limited English proficiency and health literacy, mixed immigration status in the household, fear of immigration enforcement, a complicated application process, limited access to Internet/email or telephone, low knowledge of how health insurance works, and difficulty understanding insurance company notices.

Meeting Communities Where They Are

Despite these challenges, organizations that are dedicated to reaching eligible, but unenrolled Hispanic children and families are using creative and community-focused outreach strategies to overcome these disparities in access and improve health outcomes. The Connecting Kids to Coverage National Campaign recently assembled a cadre of national partners and local organizations who have been successful in engaging and enrolling Hispanic children and parents. They shared insight on the Campaign's September webinar. Below are four key takeaways:

  1. Know Your Audience

    Understand the needs of the communities you're targeting, including preferred language and outreach methods. As you build out your strategy, assign both staffing and budget resources around those needs. Zero to Three uses text messaging through its Text4baby program to reach Latina mothers. Knowing this population prefers to receive well-baby messages via text message based on their higher overall engagement rate compared to other mothers, they have seen success enrolling pregnant women and young mothers and connecting them to important health coverage information with their messaging. One round of text messages detailed the start and end of Open Enrollment for the participating mothers and another set of messages pointed participants to resources about how to save money on monthly premiums or out-of-pocket costs.

  2. Collaborate with established and trusted community groups.

    The National Alliance for Hispanic Health (NAHH) is dedicated to building strong, healthy communities and collaborating with leading community-based organizations and national partners to improve the well-being of Hispanic families. In addition to their national campaigns, NAHH partners with other trusted local organizations and groups such as schools, churches, and cultural associations for the ¡Vive tu Vida! Get Up Get Moving! events. The events take place in 11 communities with 11 events scheduled per year. The communities include Phoenix, Chicago, Los Angeles, Orlando, New York City, Houston, and Puerto Rico where 400 community partners are involved with the events each year. Since 2007, these events have successfully reached more than 150,000 through 81 events with 86 percent attending as a family. In addition to free health and dental screenings, local agencies are present to provide enrollment information and NAHH's own certified navigators attend the events to talk to participants about healthcare coverage, making a particular effort to engage agencies that provide Medicaid and CHIP information.

  3. Use a personal touch.

    With a bicultural and bilingual staff, Connecting Kids to Coverage grantee California Coverage & Health Initiatives (CCHI) uses a patient navigator model and works with state and county partners to identify and enroll families in Medicaid or CHIP. Counselors at community health centers and partner sites provide in-person enrollment assistance. Families have a primary contact throughout the enrollment process. CCHI has noted that counselors build a level of trust with families and provide additional support through the process, as needed.

  4. Follow up.

    From the initial referral all the way to renewal, following up with families at various steps of the enrollment process helps ensure that families are covered and are accessing the key benefits of Medicaid and CHIP. The Brownsville Community Health Center uses its community partnerships and navigator program to establish visibility in the Hispanic community. Navigators hold evening and weekend office hours at convenient community locations to accommodate working parents, and their Promotoras/Community Health Workers conduct home visits. These navigators schedule follow ups with families both over the phone and in person and make sure to check in at important times, including Open Enrollment periods and renewal. By being a constant companion for families throughout the process makes the continuum of care simpler and more accessible to the most vulnerable families.

Bilingual Resources

All of the Campaign’s materials in the Outreach Tool Library are available in English and Spanish, including images and web buttons for online media, social media messages, PSA scripts, and ready-made article templates for placing information in community newspapers, school newsletters, church bulletins, local community organizations, websites and blogs. These materials can be customized with your organization's logo and contact information for free.

Stay Connected with the Campaign

  • Share our materials widely. We have an ever-growing Outreach Tool Library featuring resources to use in outreach and enrollment efforts, including materials in other languages.
  • Contact us to get more involved with the Campaign at ConnectingKids@cms.hhs.gov
  • Follow the Campaign on Twitter. Don't forget to re-tweet or share our messages with your network or use our #Enroll365 and/or #KidsEnroll hashtags in your posts.

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