"No One Asked Me"

Latinos' Experiences With Massachusetts Health Care Reform

This report presents accounts from a qualitative study funded by the Robert Wood Johnson Foundation (RWJF) that examined the personal experiences and financial impact of the 2006 Massachusetts health care reform act (Chapter 58 of the Acts of 2006) among low-income Latinos.

Twenty interviews were conducted with Latinos who had obtained health insurance coverage after the law’s enactment. Data from the interviews indicates that once informed about the insurance law, participants became active agents seeking affordable health insurance coverage. However, they felt intimidated by the health insurance enrollment process, and thus sought assistance from a community-based multi-service program—a program that provides case management-like services.

Although affordable monthly insurance premiums for low-income residents can be determined by simply using an affordability scale, participants’ views of affordable insurance involved a more complex calculus. Due to changes in their day-to-day financial circumstances, participants continued to reconsider whether their health insurance premiums were affordable.

Findings indicate that the health insurance enrollment process is notably complicated for low-income Latinos, and more so for those who face language barriers and lack of familiarity with use of health insurance. Without the help of a community-based program, participants’ success in obtaining health insurance coverage was unlikely. As a model for future national health reform, the enrollment experience of Latino residents in Massachusetts described in this report suggests the need to implement communication strategies to inform linguistically-diverse populations about the steps to follow to comply with health insurance mandates. Also, findings point to the need to equip community-based organizations with the necessary tools to assist individuals with limited experience with health insurance during their process of obtaining affordable health insurance.