People across the country have the opportunity to sign up for health insurance until Dec. 15 when the open enrollment period comes to a close. But despite a few programs here meant to aid people sign up for coverage, a large percentage of the Rio Grande Valley’s population remains underinsured.
One of the likeliest barriers to getting people to sign up for health insurance is one culprit we’ve heard so much about in the last few years — misinformation.
“I think that, obviously in the Valley, we have the same problem we always have with how do you get the word out with accurate information to people, and that’s not easy,” said Anne Dunkelberg, associate director of left-leaning Every Texan, an Austin-based nonprofit policy research and advocacy organization, formerly named the Center for Public Policy Priorities.
“Frankly it requires people to be able to get information from somebody they trust,” Dunkelberg said. “And then it requires for the people they trust to have good information to give them.”
Getting correct information is vital for people in mixed-status households who worry that trying to coverage for one family member who is a U.S. citizen could affect another family member who is undocumented or who is a permanent resident.
“This is not by any means isolated to the Valley,” Dunkelberg said. “(But) it’s as big an issue in the Valley as it is anywhere else in Texas.”
She explained that if parents are undocumented, their status doesn’t affect the eligibility of their U.S. citizen children for Medicaid of the Children’s Health Insurance Program (CHIP).
“But families don’t necessarily know that and they have lots of fears about immigration consequences that may keep a whole family from getting coverage when, in fact, maybe almost everybody in the family could qualify for coverage, or at least all the kids,” Dunkelberg said.
“Now, I don’t want to oversimplify that problem because it’s not just a problem of misinformation,” Dunkelberg added, “we’ve also have had four years of a federal administration…it’s been very anti-immigrant and has deliberately changed federal policies to actually make it harder for families to access benefits and, specifically, has changed them in ways that make it even more confusing and that increase the amount of fear and misinformation.”
Roxanne Pacheco, the interim executive director of Hope Family Health Center in McAllen, said she agreed that those fears played a role.
“We hear it from our clients,” Pacheco said. “Many of them that may be going through the legalities of becoming a resident, they have this intense fear and it’s a valid, real fear as far as them not seeking any sort of help for themselves. However, what happens is they generalize it to the whole family.”
Hope Family Health Center is a nonprofit organization that provides medical, counseling, behavioral and other services to the uninsured in the Valley.
To try to combat those fears among their clients and the rest of the uninsured population, Pacheco believed it was about education and increasing health literacy.
“For example, often times what I hear back from people is ‘Oh, I didn’t know that you all saw the uninsured’ and this is a nonprofit that’s been around for 24 years,” she said.
Another key, she said, is learning to speak their language, both literally and figuratively.
“A lot of these are Spanish-speaking people and we’re not speaking in their language,” Pacheco said. “We’re not telling them or validating that yes, your fear may be valid, however, this is a portion that you’re not being informed about.”
Validating and normalizing, she said, is important so that their fears can subside and they can feel strong enough to pursue those benefits for either themselves or their families.
This year, the uninsured rate is expected to be higher than previous years because of the COVID-19 pandemic which has caused people to lose health care coverage they received through their employer or left the unable to afford insurance in the health insurance marketplace.
“Many of our patients, they were working and now they find themselves barely able to make ends meet,” Pacheco said. “We have had patients who previously, for example, were donors for the food bank and now they’re the recipients of what they used to donate to.”
The pandemic has also diminished the Hope center’s ability see patients and simultaneously discouraged people from seeking health services.
As a precautionary measure, many of the clinic’s volunteer physicians have foregone seeing patients or they’re only seeing them virtually through telemedicine which Pacheco said really discouraged people from attending.
On the other hand, though, the use of tele-health has driven up the number of counseling appointments which Pacheco said was likely due to the fact that seeing a therapist privately, without leaving the house, circumvents the cultural shame or stigma that could accompany that.
The clinic has about 8,000 appointments on a yearly basis. This year, appointments for medical services have decreased by at least 25% while counseling appointments increased by about 30%, according to Pacheco.
But the pandemic has caused the clinic to lose important funds, endangering the safety net they provide for the uninsured.
Their annual fundraising event held in August, the “Fishing for Hope” tournament, was cancelled this year, causing them to lose out on the estimated $300,000 it brings in annually.
“Those $300,000 goes to direct services for our patients,” Pacheco said. “That is how we’re able to do lab work, diagnostic testing, and this means that already going into 2021, which we anticipate is going to be a great year for need of care, we are already at a disadvantage.”
Realistically, she said they expect they won’t have the same capacity.
“We are anticipating that there will be a greater opportunity for grants for the coming year as a new administration comes in,” she said. “So we’re relying heavily on hope — literally on hope and faith — to get us through but, realistically speaking, we also know that the challenge is going to be great.”
Anyone interested in supporting Hope Family Health Center can make donations through their website at hopefamilyhealthcenter.org.
Pacheco said they also welcome organizations who would like to set up an information booth at their clinic to assist people who may qualify for insurance.
“So if there’s anybody that would like a space, by all means, we do open up that space,” Pacheco said, “and that would help both the uninsured that may not know what is available for family members and hopefully that will kind of just close the gap as far as that education piece is concerned.”