Minnesota's new online health insurance marketplace, MNsure, has been open for about a month, but getting the word out to hard-to-reach populations is just ramping up.
Outreach efforts have been slow to start due to delays in training navigators and finalizing MNsure's contracts with organizations who provide one-on-one help.
One of the target populations to inform about the insurance options is Latinos, who are three times as likely as white Minnesota residents to lack health insurance.
Finding 'Trusted Messengers'
When you have questions about health insurance, you may not necessarily think "beauty salon," but Clarence Jones does.
"Barbershops and beauty shops are really one of the places where people come and they talk to trusted messengers," he says.
Elizabeth Stawicki for NPR
Health workers know places like Karina Cardoso's beauty salon in St. Paul, Minn., are prime places share information about the state's new health insurance options.
Health workers know places like Karina Cardoso's beauty salon in St. Paul, Minn., are prime places share information about the state's new health insurance options. Elizabeth Stawicki for NPR
Jones is outreach director for Southside Community Health Services, one of the organizations that's sharing a $4 million federal grant to provide the boots on the ground to explain what MNsure is about and how to sign up for coverage.
Jones says they know people are concerned about their health, "so we wanted to establish some kind of relationships with barber shops and beauty shops so that we can give them information on how to access medical care, which is an issue in many communities."
On a recent Saturday, Jones and about a half-dozen of his colleagues visited Karina's Beauty Salon in the heart of St. Paul's Latino community.
They set up shop in a big, white bus parked outside and squeezed into available niches in the salon to screen customers for health problems, give flu shots and spread the word about MNsure. They call it the "clipper clinic."
The salon's owner, Karina Cardoso, says 90 percent of her customers are Hispanic. She says most are like her — self-employed with no health insurance.
"When I talk to the clients, there is a huge thing now with Obamacare, and I don't think that a lot of us know exactly what Obamacare is," she says.
An Ongoing Conversation
Southside Community Health Services worker Miguel Rivera is training to help people sign up for coverage. He says confusion about the federal health care law is common among the people he sees.
Elizabeth Stawicki for NPR
A mobile unit from Southside Community Health Services offers screenings and flu shots and shares information about the state health exchange, MNsure.
"They're totally confused. There's still a lot of information — the client has to get into it and navigate the system — but people can do it," he says.
When the five-hour clipper clinic is over, no one has signed up for health insurance.
On board the bus, health worker Heidi Benson isn't discouraged. She says up to 40 percent of Latino patients at Southside's health clinics are in the country illegally, so even people who qualify for coverage may not sign up to protect an undocumented family member.
Benson says the clinic at Karina's is only the first step in a continuing conversation about MNsure.
"I think it opens up the ability for the conversation to broaden," she says, "so people who've been afraid or don't know what questions to ask, when they hear more information, start to understand that it's OK to ask any questions ... and hopefully get the answers that they need, to go forward and take care of themselves."
Cuidado De Salud
Throughout the country, about 10.2 million Latinos are expected to qualify for health insurance under the Affordable Care Act.
Outreach through trusted networks in the community — like the beauty salon — is critical to help reach them, says Mayra Alvarez, who works in health policy for the federal Department of Health and Human Services.
"I think that's why you see that this first open-enrollment period is six months is to allow people the time to ask those questions, to become familiar with the marketplace, to make an educated decision about health insurance," she says. "For a lot of people, this is going to be the first time they have access to health insurance."
Alvarez says she hopes the Spanish version of HealthCare.gov, CuidadoDeSalud.gov, will be open to accept enrollment in a few weeks.
This story is part of a collaboration among NPR, Minnesota Public Radio and Kaiser Health News.