As Tens of Thousands of Black Californians Face IRS Penalties for Failing to Secure Health Insurance,
a New Spotlight is Turned on Shortcomings in African-American Outreach.
Ronail "Stretch" Shelton is about to be a little lighter in the pockets.
A resident of Los Angeles' Koreatown section, Shelton is among an estimated 70,000 African-American Californians expected to be penalized by the Internal Revenue Service for failing to have health insurance. Although he is one of the millions of uninsured Americans, Shelton did not enroll in benefits through the Affordable Care Act — commonly known as Obamacare. His failure to obtain health care coverage means the 31-year-old personal trainer is due to be fined $95 or one percent of his household income.
Despite heavy publicity and a deadline extension provided by Covered California (the state's healthcare exchange), Shelton was still trying to enroll after the final April 15 deadline. A few days after that, he was scrambling to mail personal information to Covered California, but the effort was in vain. "I talked to someone on [April 15]," he said. "They said I could try to still send something in. That day, their server or something went down."
He blamed his lack of health coverage on not knowing where to go, Still, the pending fine was news to him. "I didn't know anything about it until you mentioned it," Shelton said when asked to discuss his plan to pay the penalty. "Obviously, I don't want to have to pay it."
Overall, California African-American non-enrollees who were eligible for subsidy who did not sign-up by April 15 will reach fines well over $ 7.5 million for not obtaining health care through Covered California, Medi-Cal or some through other means.
In an April 17 press release, Covered California said more than three million Californians enrolled in health insurance plans or Medi-Cal by the cutoff date. The organization also said it "has met the base projection for African-American enrollment."
According to figures released by Covered California, only 21,974 eligible black Californians signed up for health coverage through Obamacare. Statewide, 265,000 Latinos, 194,000 whites, and 83,000 Asians enrolled between October 1 and March 31. Also, six percent of the Medi-Cal enrollees are African-American, the second lowest percentage among all ethnic groups. Thirty-eight percent of new Medi-Cal enrollees are Latino, 27 percent are white, 17 percent are Asian, and nine percent self-identified as "other."
To many, these numbers are simply unacceptable. California Assemblymember Cheryl Brown said she and other members of the California Legislative Black Caucus believe the target of 22,000 black enrollees was far too low — especially in light of the fact that blacks are six percent of the population in a state that had an estimated seven million uninsured residents prior to Obamacare.
"While they were close to their initial projection, clearly their outreach to the African-American community needed to have sufficient funding to achieve larger participation and enrollment," said Brown, a Democrat who represents 47th Assembly District. "In addition, there seems to be a problem with identifying and employing the most effective communication networks to reach African-American communities."
Dr. Michael A. Lenoir, an Oakland allergist and president-elect of the National Medical Association's Allergy and Asthma Section, said education and outreach will be key to reaching black Californians when the second round of Obamacare enrollment begins in the fall.
As Lenoir sees it, Covered California's outreach to African-Americans began too late, and did not effectively utilize black newspapers and radio. Considering the health care exchange's $85 million marketing budget, he called the level of black outreach "pitiful."
"There are no challenges, just will," said Lenoir, who is also host and executive producer of the "About Health" program on Pacifica Radio. "The effort to reach African-Americans was never robust. I don't think there was enough outreach to African-Americans on not only what [Obamacare] is, but how to access it."
With so many questions remaining, Lenior, whose show broadcasts in the Bay area, said education and outreach will be key. He devotes every third program to the topic, and believes strongly that partnerships between black health professionals and black media organizations are crucial. Later this month, his show will begin hosting radio town hall meetings to discuss Obamacare and other health issues.
"I want to be able to reach the African-Americans out there drinking gin and juice," he said. "My whole career, I have been trying to address the problems of people who listen to the radio."
Brown, whose district stretches from Grand Terrace to Muscoy, said the Black Caucus recently met with Covered California officials to express concern about the African-American enrollment numbers.
"Covered California indicated they are going to review their efforts and make any necessary changes and provide the funding to improve African-American outreach and increase the number of enrollees," she said. "We look forward to working with them as we approach the next open enrollment period."
As for non-enrollment penalties, Brown said reactions to the IRS bill will likely depend on the depth of knowledge about Obamacare. "If people are not made aware of the advantages of having health care," she said, "they will simply ignore the law and not participate — regardless of the threat of a fine."
Shelton, the personal trainer in Los Angeles, said he isn't looking forward to that bill.
"I guess," he said with an air of resignation, "I will just have to pay it."