Awareness of public exchanges among the Latino population is running into a language barrier, according to a Commonwealth report.

Latinos living in the U.S. who are eligible for health coverage under the Patient Protection and Affordable Care Act (PPACA) are taking action to get health insurance. But signs indicate that not all who qualify for the free or reduced-premium coverage are taking advantage of it.

A Commonwealth Fund study found that in states that have expanded Medicaid coverage, the uninsured rate of Latinos fell significantly. Meantime, in the 25 states that have not done so, there was virtually no change in the uninsured rate.

Overall, the numbers look good, Commonwealth said, especially among Latinos ages 19 to 34, where the uninsured rate dropped from 43 percent to 23 percent in April–June 2014, after PPACA’s first open enrollment ended.

“The uninsured rate among non-elderly Latino adults speaking predominantly Spanish, a group historically among the most likely to be uninsured, dropped from 49 percent to 30 percent. Nearly seven of 10 (68 percent) Latinos with new coverage through the Patient Protection and Affordable Care Act were uninsured prior to obtaining this new insurance,” Commonwealth reported in a brief, Catching Up: Latino Health Coverage Gains and Challenges Under the Affordable Care Act, Results from the Commonwealth Fund Affordable Care Act Tracking Survey.

However, the report said, “there are stark differences in Latino uninsured rates in states that have expanded Medicaid and those that have not. In the 25 states and District of Columbia that had expanded Medicaid by the time of the survey, the uninsured rate for Latinos fell from 35 percent to 17 percent. In states not expanding Medicaid, the uninsured rate for Latinos remained largely unchanged at 33 percent.”

Some 20 million Latinos live in the states that haven’t expanded Medicaid, most of them in Texas and Florida.

Slicing and dicing the data, Commonwealth said 80 percent of the uninsured were ages 19 to 49, and 60 percent of them would qualify for coverage through Medicaid if that was available to them.

“About 16 percent of Latinos who remain uninsured are likely still ineligible for the law’s coverage options due to their immigration status,” Commonwealth said.

Other highlights from the study:

  • Latinos whose incomes make them eligible for Medicaid had the largest coverage gains, moving from 46 percent without insurance to 28 percent;
  • 29 percent of Latinos who were potentially eligible for coverage via public exchanges or Medicaid shopped for coverage, compared to 47 percent of non-Hispanic whites potentially eligible for the law’s coverage options;
  • Awareness that the public exchanges existed was low among Latinos who speak primarily Spanish, at 35 percent;
  • Latinos who spoke primarily English were twice as likely to visit the marketplaces than Latinos who spoke primarily Spanish;
  • 58 percent of Latinos who visited the marketplaces found it easy to find a plan they could afford compared with 38 percent of non-Hispanic whites;
  • 66 percent of Latinos who visited the marketplaces selected a plan or enrolled in Medicaid compared with 47 percent of non-Hispanic whites. 

“This survey makes it clear that uninsured Latinos want the security of quality, affordable health coverage,” said Commonwealth Fund President David Blumenthal, M.D. “For Latinos to fully benefit from the Patient Protection and Affordable Care Act, however, expanding Medicaid will be key, as will be efforts by state and federal officials to raise awareness of the marketplaces among Latinos and provide assistance to those looking for health insurance.”