AP: The Spanish ObamaCare website is just about as awful as the English version 
 
 posted at 5:01 pm on January 12, 2014 by Erika Johnsen 
 
 What was initially supposed to be what Spanish-speaking Americans were assured was a trifling delay of merely three weeks soon became a delay of more than two months, and the Spanish-language version of HealthCare.Gov didn’t end up opening for business until December 6th — less than a few weeks before the deadline to obtain January-1st coverage. Much like the debut of the English version of HealthCare.Gov, however, Spanish speakers have been encountering their own slew of functionality problems in the very belatedly available opportunity to signup online, via the AP: 
 
 And the translations were so clunky and full of grammatical mistakes that critics say they must have been computer-generated — the name of the site itself can literally be read “for the caution of health.” “When you get into the details of the plans, it’s not all written in Spanish. It’s written in Spanglish, so we end up having to translate it for them,” said Adrian Madriz, a health care navigator who helps with enrollment in Miami. … In New Mexico, the state with the nation’s highest percentage of Latino residents and where more than 20 percent of the state’s population goes without health insurance, fewer than 1,000 people total signed up for coverage in October and November. … “In my opinion, the website doesn’t work,” said Grettl Diaz, a 37-year-old Miami gas station cashier who is originally from Cuba. Diaz said she tried to sign up at home using CuidadoDeSalud.gov. After she couldn’t get the website to accept a scanned document, she called the government’s Spanish hotline seeking help. However, she was repeatedly told to call back because the site was down. She got through days later and waited over an hour for an operator before she was ultimately disconnected. 
 
 And I would imagine that all of the technical medical and financial lingo it takes to describe health insurance plans makes the computer-generated translations all the more difficult to navigate. Obama administration have been quick to point out, much like they were in the glitch-riddled rollout of the English version, that there have been paper and phone options available to Spanish speakers all the while, but there’s just no getting around the fact that yet another one of their grandiose ObamaCare promises — in this case, to concentrate major resources in the effort to provide easy access to a group with among the highest uninsured rates in the nation — has fallen tremendously, incompetently flat. 
 
 Related Posts: ||||| ALBUQUERQUE, N.M. (AP) — Mirroring problems with the federal health care website, people around the nation attempting to navigate the Spanish version have discovered their own set of difficulties. 
 
 In this Wednesday, Jan. 8, 2014 photo, Yolanda Madrid of Miami, left, talks with navigator Daniela Campos, right, while signing up for health insurance under the Affordable Care Act, in Miami. Mirroring... (Associated Press) 
 
 The site, CuidadoDeSalud.gov, launched more than two months late. 
 
 A Web page with Spanish instructions linked users to an English form. 
 
 And the translations were so clunky and full of grammatical mistakes that critics say they must have been computer-generated — the name of the site itself can literally be read "for the caution of health." 
 
 "When you get into the details of the plans, it's not all written in Spanish. It's written in Spanglish, so we end up having to translate it for them," said Adrian Madriz, a health care navigator who helps with enrollment in Miami. 
 
 The issues with the site underscore the halting efforts across the nation to get Spanish-speakers enrolled under the federal health care law. Critics say that as a result of various problems, including those related to the website, many people whom the law was designed to help have been left out of the first wave of coverage. 
 
 Federal officials say they have been working to make the site better and plan further improvements soon. Also, administrators say they welcome feedback and try to fix typos or other errors quickly. 
 
 "We launched consumer-friendly Spanish online enrollment tools on CuidadoDeSalud.gov in December which represents one more way for Latinos to enroll in Marketplace plans," said Health and Human Services Department spokesman Richard Olague in an email to The Associated Press. "Since the soft-launch, we continue to work closely with key stakeholders to get feedback in order to improve the experience for those consumers that use the website." 
 
 Still, efforts to enroll Spanish-speakers have fallen short in several states with large Hispanic populations, and critics say the translated version of HealthCare.gov could have helped boost those numbers. 
 
 In California, officials have acknowledged the need for improvements, saying fewer than 5,500 people signed up for health care in Spanish in October and November, the most recent period for which records are available. About 4.3 million California residents speak only Spanish, according to census data. It's not clear how many of these residents are without health insurance, but observers say few groups are more vulnerable. 
 
 "Spanish speakers are typically the ones who need to sign up for health insurance," said Veronica Plaza, a professor who teaches medical Spanish at the University of New Mexico. "They are the ones who could use the support." 
 
 In New Mexico, the state with the nation's highest percentage of Latino residents and where more than 20 percent of the state's population goes without health insurance, fewer than 1,000 people total signed up for coverage in October and November. 
 
 In Florida, federal health officials have not said how many of the state's nearly 18,000 enrollees for October and November were Latino, but that group accounts for about one-third of the roughly 3.5 million uninsured people in the state. About 1.2 million people in the state speak only Spanish. 
 
 Across the U.S., about 12 percent of the 317 million people in the country speak only Spanish, but federal officials have said less than 4 percent of calls to a national hotline were Spanish-only as of last month. 
 
 Many blame at least some of the enrollment problems on the trouble-plagued site. 
 
 "In my opinion, the website doesn't work," said Grettl Diaz, a 37-year-old Miami gas station cashier who is originally from Cuba. 
 
 Diaz said she tried to sign up at home using CuidadoDeSalud.gov. After she couldn't get the website to accept a scanned document, she called the government's Spanish hotline seeking help. However, she was repeatedly told to call back because the site was down. She got through days later and waited over an hour for an operator before she was ultimately disconnected. 
 
 "I'm very frustrated," she said through a translator this month. "I've spent at least one week on the phone, and I couldn't get it done." 
 
 Diaz, who speaks very little English, finally went to a counselor for help and is now waiting for an email from health officials saying she can proceed with her application. 
 
 Diaz hasn't had insurance since moving to Florida two years ago. She will likely qualify for a tax subsidy to help pay her monthly premiums and has said she wants insurance mostly for peace of mind. 
 
 "Now, I am healthy," she said. "But I don't know what will happen tomorrow." 
 
 Such stories have frustrated Latino advocates, especially since the problems with the site come after an unprecedented collaboration between competing Spanish-language media outlets and Latino businesses, urging members of their communities to sign up for health care on Oct. 1. But advocates say despite promises from federal officials, the Spanish-language site was not up until Dec. 6. 
 
 "In many states, groups were cooperating and ready to go," said Patricia Perez, a partner of the VPE Public Relations, a Pasadena, Calif.-based firm that focuses on U.S. Latinos. "It was a missed opportunity." 
 
 Univision Communications Inc., which runs the largest Spanish-language media network, has been airing daily public service announcements about the health care overhaul. It hosted and aired a live town hall meeting out of Los Angeles last month to discuss the law, and another such event has been planned for February. 
 
 The network frequently airs segments about the Affordable Care Act on its weekend health shows, and it produced a documentary exploring obstacles Latinos face signing up for health insurance, network spokesman Jose Zamora said. 
 
 The film, featuring a 19-year-old Mexican-American whose father suffered three heart attacks with no insurance aired Dec. 1 — five days before CuidadoDeSalud.gov went live. 
 
 Since the site has been active, users have reported disappointment and frustration in both the functionality and language. 
 
 For example, links comparing insurance plans took users to the English version of the options. That glitch was fixed last week after The Associated Press contacted Health and Human Services to ask about the problem. 
 
 As for the language, Plaza, the New Mexico professor, said a recent examination by her research students concluded that the translations were done "by a computer-generated process" and came across as awkward. 
 
 "There are problems with the verbs and word order that make sentences hard to understand," said Plaza, who helped develop an audio version to help residents in New Mexico sign up. 
 
 "Sometimes," she added, "it's just the terms they use." 
 
 The website translates "premium" into "prima," but that Spanish word is more commonly used to mean a female cousin, Plaza said. A more accurate translation, she said, would be "cuotas," ''couta mensual" or "costo annual." 
 
 According to Health and Human Services, the website was translated with the same methods and team used to translate content into Spanish for the Centers for Medicare & Medicaid Services. 
 
 But health care workers in Miami also have reported technical problems that don't exist on the English version of HealthCare.gov. 
 
 Nini Hadwen, a health care navigator, said she also prefers to use the English website even when she's enrolling Spanish-language applicants. CuidadoDeSalud.gov "doesn't navigate as smoothly from page to page," she said. "It takes longer." 
 
 Also, navigators say Spanish-language applicants must provide income and immigration documentation. Frequently, applicants are required to scan and fax supplemental documents, which can also be challenging, as Diaz's case shows. 
 
 However, Jane Delgado, president and CEO of the National Alliance for Hispanic Health in Washington, D.C., defends the site, saying Friday that delays were merely "part of the process" and that she was confident federal officials would get it running better soon. 
 
 "Insurance is way complicated. It's not like paying for a cellphone," she said. "Technology is only part of the answer." 
 
 Overall, Delgado said Spanish-speaking Latinos will benefit from the federal overhaul in the long-term because the population is less likely to be insured compared with other groups. 
 
 Still, Gabriel Sanchez, a political science professor at the University of New Mexico, said the problems hurt the credibility of federal officials and reinforce the belief held by some that authorities are indifferent to the plight of Latinos. 
 
 Sanchez said, "They will look at this, and think, 'Man, they really don't care about us.'" 
 
 ___ 
 
 Kennedy and Associated Press writer Laura Wides-Munoz contributed to this report from Miami. 
 
 ___ 
 
 Follow Russell Contreras at http://twitter.com/russcontreras . ||||| Health care Many Spanish speakers left behind in first wave of Obamacare Dec. 26, 2013 at 2:18 PM ET 
 
 In Silicon Valley, the executives and engineers who’ve helped build the Apple, Google and Facebook empires earn high salaries and enjoy a slew of perks, including stellar health benefits. 
 
 The clients of the Ravenswood Family Health Center, a community clinic in East Palo Alto just two miles away from Facebook’s sprawling headquarters, live in a very different Silicon Valley. 
 
 They’re the gardeners, nannies, factory workers and service staff who keep Silicon Valley homes and offices humming, the lawns manicured and the families comfortable. 
 
 They are also, in many ways, a microcosm of the population the Affordable Care Act was meant to help. 
 
 Many earn between $5 and $15 an hour, don’t own or use computers and are more comfortable speaking Spanish than English. Sixty-five percent of East Palo Alto’s population is Latino, a group seen as crucial to the success of the health law. Many lack health insurance and pose a lower financial risk because they are typically younger and healthier than others. 
 
 Kaiser Health News 
 
 Yet California, with the greatest number of Latinos in the country, is far behind in reaching this population. And across the nation, the picture appears even worse. 
 
 Those who primarily speak Spanish are largely being left out of the first wave of coverage under Obamacare. Many missed this week’s deadline for enrollment in plans beginning Jan. 1. People who want to be covered for any part of 2014 must sign up by March 31. 
 
 In part, the lag in sign-ups among Spanish speakers reflects a digital − and a cultural − divide. Many are hesitant about handing over personal information to strangers over the Internet, advocates say. This group tends to be less educated, and have lower incomes and less access to technology than fluent English-speakers. 
 
 When Elizabeth Gonzalez, 31, started getting migraines her doctor prescribed medicine that cost $300. She had health insurance provided through a San Mateo County program for low-income adults, but the medicine wasn’t covered and she couldn’t afford it. 
 
 “I guess I don’t need it,” she remembers thinking. Then she started wondering whether the new health law might offer a better plan. 
 
 Gonzalez, a part-time library aide, started hunting for resources to help her decipher the Affordable Care Act. Though a Los Angeles native, she was raised in Morelia, Mexico and preferred to have the law explained to her in Spanish. 
 
 California’s health insurance marketplace, Covered California, has had a functioning Spanish-language website since Oct. 1 – which puts it ahead of most of the rest of the country. But Gonzalez couldn’t access the site from home because she doesn’t have Internet service or a smartphone. 
 
 “With my budget, I don’t have access to that,” she said in Spanish. “I have to limit myself to the primordial.” 
 
 Instead, she relied on staff at the county’s human services office, two floors up from the library where she works, to guide her. 
 
 Staff members there told her she needed to fill out an application and to wait for up to a month to hear whether she was eligible for Medi-Cal − California’s insurance program for the poor. Discouraged, she made repeated telephone calls to the hotline for Covered California. 
 
 “There’s no one picking up, probably because there’s not enough people,” she said. “We need more information in poor communities and places to help you fill out forms so you know you’re doing it correctly. There’s not enough [information] in Spanish.” 
 
 According to the latest data released by the state, less than 5 percent of California’s roughly 110,000 signups in October and November were completed in Spanish. 
 
 Statewide, Spanish-speaking operators at Covered California call centers, as well as navigators who can walk people through enrollment, are in short supply. The section on the Spanish version of Covered California for requesting help with enrollment still links to an English website. 
 
 In other parts of the country, Spanish speakers are worse off. 
 
 In the 36 states that rely on the federally run insurance exchanges, including Texas and Florida, Latinos until recently couldn’t enroll online in Spanish. CuidadoDeSalud.gov − the Spanish-friendly version of the federal marketplace − wasn’t fully working until Dec. 6, more than two months after its English counterpart, HealthCare.gov, launched on Oct. 1. 
 
 Officials decided to hold off opening enrollment on CuidadoDeSalud.gov until they addressed the technical glitches plaguing the English version. Even now, the Spanish website is rife with grammatical errors. 
 
 Federal officials note they have bilingual call centers, but Spanish-only calls to the federal exchange’s call centers barely totaled 180,000, or the equivalent of 3.5 percent of all calls, as of Dec. 10. 
 
 Unlike English speakers, Latinos who speak Spanish still don’t have the option to window-shop for plans before creating an account. The section in which customers can consult plans before signing up with a username and password is still non-existent in Spanish. 
 
 With many Latinos missing the deadline to be enrolled for coverage in the new marketplaces on Jan. 1, community organizers have shifted their attention to March 31, when the enrollment period for 2014 officially closes. Consumers who don’t enroll by this date will face a penalty. Medi-Cal enrollment will remain open, however. 
 
 “Most of our community is going to be focused on that March 31 deadline, and that’s where the big push will be,” Jane Delgado, the president and CEO of the National Alliance for Hispanic Health, an advocacy group based in Washington D.C., said earlier this month. “I’m less concerned about getting everybody enrolled quickly than about getting people enrolled in plans that fit their needs. I have no doubt people will enroll. They just need better information and local navigators they can trust.” 
 
 Adding to their worries, Latinos living in households with undocumented relatives often fear that signing up for a government run program will lead to unwanted scrutiny and even deportations. Others are wary of getting cheated or having their personal information hacked online. 
 
 Mindful of the mistrust, Ravenswood has been careful to develop a bond with its patients. 
 
 The clinic has eight certified enrollment counselors to help clients determine what kind of insurance they need and can afford. 
 
 “The majority of people coming in are people who we have to help 100 percent. We’re both translating and explaining everything, even when they do speak English,” said Ravenswood CEO Luisa Buada. “In general, everyone really, really wants someone to hold their hand through the whole process.” 
 
 Maria Garcia, 51, is among the roughly 200 people Ravenswood has screened or enrolled since October 1. Garcia, whose husband supports the family with his manufacturing job, went for help in part because she was concerned about fraud. 
 
 “Latinos − we don’t trust easily,” she said. “We wanted to be sure this wasn’t a scam.” 
 
 Garcia doesn’t speak English and though she has a computer at home, “I haven’t learned to use it,” she said. She generally relies on her children to search the Web for her and to translate the information she needs. 
 
 This time, the staff at Ravenswood helped her. Starting in January, she’ll be paying $36 a month for coverage for her and her husband thanks to a government subsidy. 
 
 After her discouraging experiences with the county office and the various hotlines, Gonzalez ended up at Ravenswood as well. It was just across the street from the library. Staffers quickly told her she qualified for Medi-Cal. Her migraine medication will now be covered. 
 
 “I was happy,” she said. 
 
 Ravenswood’s counselors are booked solid through the end of January. Buada and her staff have set up six enclosed booths, each with a small table, a chair, a Lenovo computer and a wrap-around black-and-white curtain, so that people who don’t have a computer or Internet access at home can feel comfortable coming in. 
 
 “We are very good with cellphones or email, but to use that website, you actually have to have access to a computer. That’s a problem,” said the National Alliance for Hispanic Health’s Jane Delgado. 
 
 Even with the possibility of federal subsidies, some Latinos can’t afford coverage and will remain uninsured. 
 
 The median income for an East Palo Alto household is roughly $50,000, compared to a median income in the county of nearly $90,000. (On average, East Palo Alto households consist of four people compared to three countywide.) Often, 75 percent to 80 percent of a poor family’s income is spent on housing. 
 
 “We’ve had a lot of people come in interested,” Buada says. But when they see how much it’s going to cost, “they say, ‘I can’t pay for this,’ and leave.” 
 
 Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente. ||||| HIALEAH, Fla. — The unlikely epicenter of Obamacare lies in a solidly Republican working-class town just 10 miles outside the Miami stomping grounds of Jeb Bush and Marco Rubio. 
 
 The city of Hialeah — a Cuban-American neighborhood of Spanish speakers that is blanketed with Obamacare advertisements — enrolled more people under the Affordable Care Act than anywhere else in the country. 
 
 Story Continued Below 
 
 That coverage is now at risk. The Supreme Court this month will decide whether Obamacare’s tax subsidies can go to people in 34 states, such as Florida, that did not set up their own health insurance exchanges. Hialeah brings to the fore the political consequences for the GOP if some 6.4 million people — including the reliably Republican voters here — suddenly lose their health insurance subsidies this summer. 
 
 “There’s a lot of folks who took advantage of the marketplace and are now potentially going to be impacted tremendously by the case if it goes the other way,” said Nicholas Duran, the Florida state director for Enroll America, a White House-aligned nonprofit that helped create the sign-up momentum in this state. 
 
 Neither the Republican lawmakers who represent this community in Congress nor the national GOP have decided whether or how to respond if the court cuts off the subsidies and voters blame them for millions becoming uninsured. Some Republicans favor restoring the subsidies — if they can repeal big parts of the health care law. Other conservatives want to ride out the political consequences by promising to build a new and better health care law on the wreckage of Obamacare. 
 
 Florida was a top target for Obamacare advocates, who ran an exceptionally strong outreach and enrollment campaign here. About 1.4 million people now have coverage in Florida — more than in any other state. And 93 percent of them got subsidies, higher than the national average. South Florida was particularly fertile ground; the top 15 ZIP codes for enrollment all run from Miami to Fort Lauderdale. 
 
 Hialeah beat them all. More than 52,000 people signed up in the five ZIP codes that make up most of Hialeah — 15,000 in one ZIP code alone, the top enrollment ZIP code in the country. 
 
 “Everywhere you went, it was, ‘Obamacare! Sign up for Obamacare, get a free beach ball!’” said Rep. Ileana Ros-Lehtinen, a Republican who represents part of Hialeah, and who, like all congressional Republicans, has voted repeatedly to repeal part or all of Obamacare. 
 
 The promotion, she said, was “really intense.” 
 
 Ariel Quintana, a 22-year-old Cuban-American, is one of the Hialeah residents who was happy to sign up. He likes the financial and health security. Plus the price was right — $83 for him, with an approximately $150 subsidy, per month. 
 
 But Quintana, who said he didn’t know anything about the Supreme Court case that could end his subsidy as soon as this summer, said he would likely drop his coverage if he had to pay for it all himself. 
 
 “To be honest, at my age, being a healthy person, I wouldn’t do it,” he said in Spanish, adding that most of his friends and family who have bought Obamacare plans like them. 
 
 Quintana and his neighbors in Hialeah are an unlikely juggernaut of Obamacare. The town of 233,000 people voted for Mitt Romney in 2012 and Marco Rubio in 2010. It’s a Republican stronghold in the more Democratic Miami-Dade County. 
 
 “Historically, Hialeah has tended to be very Republican and very anti-government programs, so with Obamacare, you can imagine those kind of messages would be received negatively,” said Duran. “But when folks begin to get the facts of what is Obamacare, focusing in on the messages about [coverage for people with pre-existing conditions and financial security], it helped Obamacare bubble to the top.” 
 
 Drive down any street in Hialeah today, and it’s hard to not run into a sign advertising “Obamacare” and displaying the Obama campaign’s signature “O” with a sunrise — even though the regular 2015 enrollment season is over and the next one won’t start until November. Health centers have hung banners. Insurance brokers — tucked in strip malls between Cuban restaurants and check cashing centers — hawk Obamacare in their storefronts. Signs tout “Obamacare aqui” and “Obamacare enroll here.” 
 
 The need here was great. As of 2013, about 37 percent of Hialeah residents were uninsured, according to census figures. Just as many were on public insurance, either through Medicare or Medicaid. Only about one quarter of Hialeah residents reported having insurance coverage through a job. 
 
 Maria Azqueta, a 52-year-old Miami resident who works at Citrus Health Network in Hialeah, said most people have separated the politics of the law from the insurance it provides. 
 
 “I hope, I think, that outside of the political side of things, this idea of health care for everyone is a good idea,” Azqueta, who signed up for a plan under Obamacare, said in Spanish in her small office at Citrus, where she promotes cancer screenings among the uninsured and underinsured. “It seems to me like a good idea for people who work as well as people who don’t work, because we all have the right in a country this free with rights [that] everyone has a right to access to health care.” 
 
 All that could change soon. 
 
 If the Supreme Court rules against the White House, about two-thirds of people who are receiving subsidies would drop their health care coverage, according to an estimate by the Urban Institute. The people most at risk of losing subsidies are predominantly Southern, white, employed and make modest incomes, according to the study. Those are the demographics of Southern Republican voters. 
 
 Pre-empting the political battle to come if the challengers win, Democrats have already said Republicans are to blame for backing the lawsuit and failing, so far, to put forth a workable plan to restore the subsidies. 
 
 Rep. Mario Diaz-Balart, a Republican who has represented part of Hialeah since 2003, is expecting Democrats to quickly introduce a bill to restore the subsidies. 
 
 “Here’s what Obama would do: The Democrats are going to say it just takes a one-page bill,” he said. “And that’s going to be the pressure” on Republicans. 
 
 He doesn’t want to see his constituents lose their health insurance, but he’s not ready to support a Democratic fix that he says would permanently entrench a “disastrous” law. Like most House Republicans, Diaz-Balart wants his party to have a “doctor-patient-centered” health plan ready to go in case the court upends the law. 
 
 Ros-Lehtinen wouldn’t say whether she would want to restore the subsidies if the court strikes them. 
 
 “We’ll have to see,” she said. “It’s always doomsday, but we’ll wait to see what the decision says and how they rule.”
– Welcome to ObamaCare's website woes, part two: the Spanish version. Americans who visit CuidadoDeSalud.gov to enroll for ObamaCare say it's slow, has links to English-speaking pages, and poor translations—like using "prima" for "premium" even though the Spanish word is commonly used for "female cousin," the AP reports. "When you get into the details of the plans, it's not all written in Spanish," says a health care navigator who helps people enroll in Miami. "It's written in Spanglish, so we end up having to translate it for them." So attempts to enroll Spanish-speakers seem to be flailing so far (the exact numbers aren't in) and critics are pouncing; Hot Air calls it yet another "grandiose" ObamaCare promise that falls "tremendously, incompetently flat." But the Obama administration notes that Spanish speakers have been able to use phone and paper options to enroll. And that may suit some Hispanics better, according to an NBC News report on health care among low-wage, Spanish-speaking workers near Silicon Valley. Many of them say they have no Internet connection and wouldn't feel comfortable handing over personal information online.