HealthCare.gov's new EZ application for coverage can't be used by legal immigrants or naturalized U.S. citizens, prompting concern that many Hispanics and Asians will go right back into long enrollment queues this year.
The Obama administration has placed a high priority on signing up more Latinos under the health care law for 2015. As the nation's largest minority group, Hispanics tend to be younger and more likely to be uninsured. An administration official says there have been significant improvements in the application process for immigrants, and more are expected in the future.
Continue Reading Below
But advocates are unimpressed.
"The whole idea was that HealthCare.gov was going to be a seamless and easy process, but that doesn't seem to be the case for immigrants," said Alvaro Huerta, an attorney at the National Immigration Law Center in Los Angeles. "I think this is happening because the federal government hasn't taken the steps necessary to resolve issues with their verification system."
President Barack Obama's law offers taxpayer-subsidized private health insurance for people who don't have access to coverage on the job. Open enrollment for 2015 starts Nov. 15. It's estimated that 6 million more people will enroll for next year, bringing the total to about 13 million.
While immigrants living in the country illegally cannot get coverage, millions who are lawfully present are entitled to the law's benefits, as well as people who were born overseas and later became U.S. citizens.
The administration is highlighting a simplified online application as one the major improvements for 2015. Most new applicants will page through 16 screens, instead of the 76 that applicants had to muddle through previously. But it turns out that immigrants and naturalized citizens are a major exception, because they're in a category the administration calls "complex cases."
Andy Slavitt, the top technology official for HealthCare.gov, said there have been several improvements to make things easier for immigrants, including expanding the list of documents that people can use to establish eligibility and updating the computer system so it won't get hung up on certain special characters used in some names.
"I wouldn't say by any means that we have achieved the best we can, but I do think we have taken appropriate steps across the board," Slavitt said. "I would suspect in future years we will be able to do more and more electronically."
People navigating the new HealthCare.gov will encounter early on a screen with a series of questions, the gateway to the streamlined application. But legal immigrants, naturalized citizens, and families in which someone is an immigrant or naturalized citizen will have to work through more screens and answer more questions.
About half of Latino adults were born abroad, according to research from the Pew Hispanic Center. Of those who have become U.S. citizens, 21 percent lack health insurance. That's well above a 15 percent uninsured rate among naturalized U.S. citizens who are not of Hispanic origin. Latinos are also more likely to be married to an immigrant.
"Immigrants could be unjustly excluded even though they are eligible," Huerta said.
Asian-American groups are also concerned.
"The problems will persist for our communities," said Bonnie Kwon, health law program manager for the Asian & Pacific Islander American Health Forum in San Francisco. "It shows a lack of commitment to provide adequate access for immigrants."
Kwon explained that many immigrants require help to get through the application. Trained helpers are in short supply. So the more time it takes to finish one application, the fewer uninsured applicants can be helped.
Slavitt disagreed that the administration has overlooked immigrants. The law's requirements mean that some people have to answer more questions and supply more documentation. He also said he thinks immigrants will benefit indirectly from the EZ application because it may free call-center operators from handling routine cases.
"The immigrant community has been a particular thrust, and more of a passion, for us," he said. "These are the people our team spent time with all of the year. If we don't make it easier for them on the front end, it will mean spending more time with them on the back end."
HealthCare.gov served 36 states this year. Huerta, the immigration lawyer, said states running their own insurance exchanges may face similar difficulties signing up immigrants because they also must use federal verification systems.