Selling Exchange as ‘El Mercado’

The Latino population will be a vital element of the new health exchange and a special effort should be made to involve them in it, according to Chad Silva of Latino Coalition for a Healthy California.

“As Latinos go in California, so will go California,” Silva said. “It’s really important that linguistic and cultural competency has to be structurally built into the exchange.”

Silva was part of a panel discussion on exchange strategy in Sacramento last week. He pointed out that projections point to a 52% Latino majority in California by 2050, and that the state is already one of the most diverse in the nation. He said the exchange would do well to court those consumers.

“Prevention and access to prevention are very important to our culture,” Silva said. “That has to be built into the system at the beginning. You need to do your outreach always with this lens.”

Kim Belshé, who sits on the exchange board, agreed.

“We want to make it a first-class retail experience,” she said, “on the level of Nordstrom. So we need to simplify eligibility and enrollment. If our state is going to be successful in implementing this no-wrong-door policy, and if we’re giving this first-class retail experience, then we need to step back and see how we do eligibility today.”

Anthony Wright of Health Access California had a pithy way of summing it up.

“Personally, I think it should be called El Mercado [“The Market”] instead of the exchange,” Wright said. “It is not your grandfather’s individual market. Two-thirds of the families in the exchange are likely to be people of color, and half of the families could be Latino.”

Wright pointed out that there’s one recurring misconception about the health benefits exchange: For some reason, Californians believe that undocumented immigrants will be helped by the exchange, even though they’re expressly forbidden to use the system.

According to panelist Alex Barrios of Axel Communications, marketing matters, particularly in trying to reach communities of color.

“We have to promote the exchange as a product, or series of products,” Barrios said. “We have to think about how to get people to sign up for the service, for coverage. Otherwise this whole thing will fail.”

Belshé said the state agency will need to look in a number of different directions in marketing the exchange.

“There are a number of tools we’ll have at our disposal,” Belshé said. “There’s also an opportunity we have in the exchange as purchasers, to identify other purchasers, such as CalPERS or the Pacific Business Group on Health, and collaborate with them.”

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