San Joaquin Valley residents have about two weeks to enroll in Affordable Care Act health plans to have coverage and avoid a tax penalty this year.
But as the March 31 open-enrollment deadline nears, the Valley has a long way to go to sign up residents for insurance through Covered California, the state's health benefit exchange created under the new health law.
As of Jan. 31, an estimated one in five people in the Valley who are eligible to enroll in the plans has done so.
Covered California shows 51,524 people enrolled from San Joaquin to Kern counties — with only 13,710 of the enrollees from Fresno, Kings and Madera counties. Statewide, 728,410 people had enrolled by the end of January. On Thursday, Covered California said a total of 923,832 people had enrolled statewide as of March 9, but county numbers were not available.
John Capitman, executive director of the Central Valley Health Policy Institute at Fresno State, said a recent UCLA survey showed 231,000 adults in the eight-county Valley region had no health insurance.
By that estimate, "about 20% of those eligible signed up" for plans through the state exchange, Capitman said.
Covered California doesn't know how many people who have enrolled in plans through the exchange were uninsured. Next year, more information will be gleaned from enrollees at the time of enrollment, the agency said.
The Valley, more than other areas of the state, faces obstacles in getting people enrolled, Capitman said.
The cost of a monthly insurance premium can scare people from enrolling, he said, and the Valley has some of the highest poverty rates in the state. "Even if it seems cheap, it seems more than people can afford."
Of Valley residents who have enrolled in plans, 90% had incomes low enough to qualify for government subsidies to offset the cost of insurance premiums.
Getting Hispanics to enroll also has been a problem statewide and in the Valley.
"Enrollment in the Latino community is lagging what we would want it to be," said Peter V. Lee, executive director of Covered California. As of March 9, Hispanics were 22% of the Covered California enrollment. According to the 2010 Census, Hispanics are 37.6% of the state's population. In Fresno County, Hispanics are 50.3% of the population.
"We knew from Day One it would be more of a challenge to enroll Latinos," Lee said. With a history of not having insurance to be overcome, Latinos are "shifting from a culture of coping to a culture of coverage," he said.
Covered California has increased television and radio advertisements aimed at the Hispanic community, but not everyone is impressed.
Miriam Gonzalez, a 26-year-old Fresno mother and part-time college student, said the state has missed the mark. Covered California pushes people to go on the Internet or telephone to enroll, she said. "People want to be face-to-face with people. No one wants to do it over the Internet."
Gonzalez said she learned about health insurance on the exchange at an event held by Centro La Familia, a Fresno nonprofit that serves people with low incomes.
Gonzalez made an appointment to enroll and said the process, "was very simple to do — but I didn't think it was going to be that simple."
Lee has emphasized the value of face-to-face enrollment at Covered California events in the state, and on Friday he repeated his pitch. "Find that person to help you that's near you now."
Personal encounters also work with healthy young adults — those ages 18 to 34 — who are so critical to the success of the Affordable Care Act.
Lee said on Thursday that young adults are about 26.5% of total enrollment. That age group represents about 25% of the state's population, but about 36% are eligible for subsidies to help pay for insurance, he said. And about 36% are eligible for Medi-Cal, the state-federal insurance for people with lower incomes.
Maria Hernandez, 21, got an introduction to Covered California during a class presentation by the Health Insurance Education Project at California State University, Fresno.
From that contact, Hernandez went home and got on the computer. But before enrolling herself, she helped her parents, who both qualified for Medi-Cal.
Unlike Covered California, there is no application deadline for Medi-Cal. Next, she enrolled a 27-year-old sister in a plan through Covered California that costs about $150 a month.
Hernandez, who is studying to be a teacher, qualified for Medi-Cal. She began a part-time job in November at a movie theater and has earned about $1,000.
Under Medi-Cal she has no insurance premium, but Hernandez said if she had to pay for coverage — up to about $100 a month — she would. She wants the coverage: "I'm sick right now," she said of a cold she was fighting.
Lee encouraged those who have enrolled to spread the word and explain "why having insurance is the cost of a cellphone bill and it's worthwhile."
And he urged people not to wait until the deadline — March 31 — to enroll.
"Tell your friends and family to sign up now," he said. "If everyone waits until the 31st, the system will absolutely slow down."
Lee said Thursday that the wait time for callers to Covered California service centers had dropped to 30 minutes — not optimal, but an improvement from an almost hour wait.
Missing the March 31 deadline to get insurance could have consequences. Most people without insurance face a tax penalty.
An adult earning less than $19,650 would pay $95, and those earning more would owe 1% of family income. No penalty is owed for incomes less than $10,150.
Covered California and Medi-Cal enrollment eventsToday: 9 a.m. to 3 p.m., St. Anthony Mary Claret, 2494 S. Chestnut Ave.
Saturday: 8 a.m. to noon, Bullard High School, 5445 N. Palm Ave., 9 a.m. to 2 p.m., Fresno Fairgrounds Gem and Minerals Building, 1121 S. Chance Ave.
March 29: 9 a.m. to 3 p.m. WeConnect Event, Fresno Fairgrounds.
Details: Clinica Sierra Vista, (559) 457-5826 or toll-free (855) 867-7216.
Today: 1-4 p.m. 13th Annual Health & Safety Fair, 45779 Road 128, Cutler.
Friday: 10 a.m. to 1 p.m. Central Valley Regional Services, 4615 N. Marty, Fresno.
Saturday: 11 a.m. to 3:30 p.m., Fresno Central Library, 2420 Mariposa St.
Details: Covered California at www.coveredca.com/events/
Staff writer Marc Benjamin contributed to this report. The reporter can be reached at (559) 441-6310, firstname.lastname@example.org or @beehealthwriter on Twitter.