When the officials who run Minnesota's health insurance exchange wanted to teach Latinos in southern Minnesota how to sign up for health care coverage, they turned to people like Charlie Mandile.
As one of the "navegadores," or health navigators who speak Spanish, Mandile is a trusted figure in Latino communities in the Faribault and Northfield areas. His skills are crucial to MNsure's ability to reach Latinos, who make up only about 5 percent of Minnesota's population, but more than 13 percent of the state's uninsured population. The organization received $32,000 to help explain MNsure to Latinos.
Around the state, advocacy groups are ramping up efforts to inform hard-to-reach populations about MNsure and the opportunity to obtain insurance through the Affordable Care Act. But getting the message to Latinos can be especially challenging without help from trusted community organizations -- especially in rural Minnesota.
"When folks are already feeling like they can't access services or things are hard to come by for them, they're going to come to folks that they trust, not a new structure or a new website," said Mandile, executive director of HealthFinders, a nonprofit with community health clinics in Faribault and Dundas.
"They want to get coverage for their kids if they're eligible, but at times there's fear, questions about, 'Should I, shouldn't I apply for my whole family? Can I apply for my kids and not myself?' Definitely a lot of questions about that," he said.
With that in mind, Mandile recently took his message about MNsure to Lincoln Elementary School in Faribault, where a dozen people sat around a long cluster of desks inside a classroom.
Mandile stood at the front of room, handing out pamphlets to the group of mostly Latino women.
"Thanks so much for coming," he said. "The topic tonight is healthcare reform...Here in Minnesota, they created their own program called MNsure. It's a website where they'll sell all kinds of health insurance. You can compare the options and see all the benefits."
Mandile said many Latinos in southern Minnesota are familiar with the term "Obamacare," but there's a lot of confusion in the community about the law, its benefits and limits.
"In the metro and in population centers there's a lot higher level of general awareness about MNsure," he said. "It seems like our starting point for general awareness for health reform and MNsure is a little bit less out here in the rural areas."
So his approach to explaining the health care law is very simple and very grassroots. He's holding small meetings, canvassing neighborhoods, and having one-on-one interactions at schools, clinics, and community centers around rural Rice County.
During the evening session at Lincoln Elementary, one of the first questions was from 33-year-old Angelica Lopez. Although she and her husband are in the United States without authorization, she wanted to know how to sign up her three U.S.-born children for health coverage. Unauthorized immigrants are not allowed to apply for insurance through MNsure, but they can obtain policies for children born in the United States.
"My priority right now is my children," Lopez said. "This makes it easier to choose from more options. This program is a good alternative."
MNsure is relying on community groups like HealthFinders to get the word out about the new health law, especially in more remote parts of the state. The agency has seven community liaisons, including four stationed around greater Minnesota, to work with more than 300 nonprofits and advocacy group partners.
Part of MNsure's outreach to Latinos also includes TV spots airing statewide on the Spanish-language television network Univision, and radio spots running in the Twin Cities.
The ads feature the agency's Paul Bunyan and Babe the Blue Ox campaign explaining in Spanish that there are more than 10,000 reasons to get health insurance.
Mary Seinko, MNsure's marketing and communications director, said distance is the biggest obstacle in rural Minnesota.
"It's going to take some time and especially when you talk about the more remote areas, the areas that are harder to reach, it does not happen overnight," she said. "It does take a little time."
Seinko acknowledges the new health care law has created confusion for many people, including populations of color. She said one-to-one interactions with trusted local organizations and community groups is what many Spanish-speaking people will need to understand -- and eventually trust -- the heath care law's requirements and benefits.
"It's not just once or twice that we need to reach them with our communications and outreach efforts," Seinko said. "It's like 10, 11, 12 times before we can really expect to see some solid results."
While he might not reach every single Latino in Rice County this year, he said his boots-on-the ground approach is the best way to introduce people to the new law, and will eventually make MNsure a household name among Latinos.
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