By Jenny Gold, Kaiser Health News
Some 10 million Latinos nationally -- including nearly 3 million in California -- stand to gain health insurance under the Affordable Care Act, and the Spanish-language media network Univision is positioning itself as a direct path to this potentially lucrative market.
WellPoint and other Blue insurers in six states, including California, have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, "Salud Es Vida," which means Health Is Life. WellPoint is the parent company of Anthem Blue Cross in California.
The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it's a path that could take a detour around some competitors who are offering plans: Because of a little-known rule proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer.
The rule allows a customer to be sent briefly to a special section of the federal or state-run marketplaces only to see if their income qualifies them for subsidized coverage, and then can go right back to the WellPoint or Blues site to buy their coverage. These customers may not necessarily see the other options for insurance available on the exchange, and the other plans may cost less or include a wider provider network.
Santiago Lucero, a spokesman for Covered California, confirmed that the agency is finalizing guidelines for such "plan-based enrollment." He said that agents will be required to read consumers a disclaimer at the beginning of the call, informing them that other options may be available.
Steve Mandala, Univision's executive vice president of sales and marketing, says that any insurer material on the plan-sponsored sites will be clearly labeled as advertisements or sponsored content and will not impact the editorial independence of Univision's news coverage.
The deals are one of the most concrete ways to date that insurers have invested in the marketing of Obamacare, but they also could skirt a key principle of the law: that it should foster insurer competition and consumer choice.
Latinos tend to be younger than the general population, so they are just the sort of consumers that insurers (and the Obama administration) hope will sign up. Because young, healthy people need fewer medical services, insurance companies can use their premiums to balance the costs of care for older or sicker patients.
"If I were Health Med or Kaiser Permanente or any of the other health plans, I might think, 'Wow, we just got out-maneuvered,'" says Daniel Zingale of the California Endowment in reference to the WellPoint partnership in California. The foundation has given Univision $20 million for a separate ACA campaign.
Consumer advocates had a mixed reaction to the rule and the Univision deals.
In San Francisco, Betsy Imholz with Consumers Union said she had concerns about "massive arrangements that are exclusive and will tend not to get people into the full array of choices." She was skeptical that the required consumer disclaimer would make much difference. She speculated that consumers would be more likely to stay with the "nice people they're talking to currently," as opposed to heading off to another site and starting the process over again.
But Imholz also said she recognized the "tough balance to strike." Signing up qualified people for insurance is a daunting challenge, she and other advocates noted.
"We really do need any boot on the ground. At the end of the day, the government will never have the money to have the kind of media campaign we need, so we need the carriers to get involved," says Elisabeth Benjamin, an advocate at the Community Service Society of New York. She says her organization and other groups working on consumer outreach can use all the help they can get to spread the word about the ACA. "My hat's off to WellPoint -- it's very clever."
In addition to the insurance sales, WellPoint, Florida Blue and Horizon BCBS will be the sole health insurance sponsor of Salud Es Vida in their respective states, which includes programming on television, radio and online.
They will also be the exclusive sponsor for a series of health newsletters that are distributed to a database of millions of Latinos. The database has some detailed health information people provided as they signed up for the newsletter, including whether or not they have insurance and if they suffer from conditions such as diabetes, hypertension and obesity.
Anthem Blue Cross is also sponsoring a health site on Telemundo, Univision's rival. It includes video content jointly created by the two companies and a link to Anthem’s site.
Lisa Rubino, a senior vice president at Molina Healthcare Inc., which is offering health plans on the California and Florida exchanges, says she’s not overly concerned about other plans having exclusive sponsorship arrangements with Univision.
Enrolling Latinos in coverage is about "more than just a media position," says Rubino. Molina already has a majority Latino customer base in California. The company's strategy is to focus on engaging with community partners such as churches, schools, markets and physicians -- the trusted advisers that Latinos generally go to for help with coverage.
Ultimately, she says, the real competition is going to be on price and network, not who has the best media buy. "When it comes down to actually enrolling, there are relationships that have been established for years beyond WellPoint and Florida Blue," Rubino says.
Lynn Quincy who works in the Washington office of Consumers Union says that despite her concerns, partnerships between insurers and other private companies like Univision may be inevitable. "Someone got into the insurance market and yelled, 'Free money! New demand!' They're all trying to figure out how to be the place where people spend their tax credit dollars," she says.
Lisa Aliferis contributed to this report.