Best practices for enrolling Latinos in health insurance: Lessons from Massachusetts' health insurance reform

Following the 2006 health insurance reform in Massachusetts, Latinos have continued to experience barriers to obtaining and maintaining health insurance coverage and receiving care. There is a lack of information about best practices for targeting and tailoring outreach and enrollment strategies to systematically address these barriers. The purpose of this study was to identify best practices among community-based organizations and health centers that provide services for Latinos in enrolling, maintaining, and using coverage.

Key informant interviews and focus groups were conducted between June 2013 - February 2014 with leadership, outreach, and enrollment staff from community-based organizations (CBOs), health centers, faith-based organizations, and social service agencies serving Latinos in Massachusetts.

Best practices for enrollment varied by organization type. Health centers reported putting in place specific strategies to prevent coverage denials.  Enrollment strategies among CBOs varied by the level of the staff’s knowledge and expertise related to health insurance coverage and resources allocated to enrollment activities. Organizations that provide direct enrollment services noted successes utilizing enrollment specialists and streamlining enrollment processes by sharing communications and applicant information. Organizations lacking resources to provide direct enrollment services served important roles as entry points to the system and in conducting advocacy and referrals. For example, CBOs that prepare taxes become entry points to health insurance coverage when they identify individuals who do not have insurance and they refer them to other organizations that provide enrollment services.

This study has lessons for organizations carrying out critical enrollment activities in response to the Affordable Care Act in states with large Latino populations.