This report from the Action for Health Justice, led by the Asian and Pacific Islander American Health Forum, Association of Asian Pacific Community Health Organizations, and Asian Americans Advancing Justice, highlights lessons learned in successful outreach and enrollment of Asian Americans, Native Hawaiians, and Pacific Islanders in health insurance through the health insurance marketplaces created by the Affordable Care Act (ACA). An estimated 1.9 million uninsured Asian Americans, Native Hawaiians, and Pacific Islanders were eligible for new options for coverage in the health insurance marketplaces and Medicaid. Over 70 national and local community-based organizations and federally qualified health centers coordinated their outreach and enrollment activities through this Action for Health Justice coalition, and collectively provide enrollment assistance to over 232,000 uninsured Asian Americans, Native Hawaiians, and Pacific Islanders.
The report documents some of the pervasive barriers to linguistic access to the health insurance marketplaces for individuals who speak and read primary languages other than English. For example, Korean translations of materials provided on HealthCare.gov contained phonetic translations of health insurance marketplace terms that lacked functional meaning. Similarly, New York’s only Korean-language flyer contained Korean characters that were incorrectly spaced and had meaningless phonetic and literal translations of English terms. In California, Tagalog translations inconsistently appeared with both Spanish and English-influenced terms, and Chinese translations appeared inconsistently with both traditional and simplified characters.
The Action for Health Justice partners implemented the following strategies to successfully conduct outreach to and enroll uninsured Asian Americans, Native Hawaiians, and Pacific Islanders:
- Fill the gap by providing quality translated materials: create and translate key outreach, education, and enrollment documents; solicit and provide community feedback and input on all outreach and education documents; publish accurate, understandable, and visually engaging materials; and disseminate information in a timely manner
- Use in-person, in-language assistance: set up one-on-one appointments, present in-language to larger audiences, utilize bilingual staff
- Build partnerships with small businesses, public officials and government agencies, faith-based organizations, schools, colleges and universities, and ethnic media; provide technical assistance for small organizations
- Engage consumers by working in the community, opening enrollment storefronts, understand sources of mistrust and develop trust in the community