New Results from the Colorado Latino Health Care Survey

A new poll of Latino/Hispanic adults in the state of Colorado strongly suggests that the United States federal government needs to do much more outreach to Latinos regarding the Affordable Care Act (ACA). The poll, commissioned by Adelante con la Salud: Latino Health Care Engagement Project and administered by Latino Decisions, queried 401 Latino/Hispanic adults living in Colorado regarding their knowledge of the new health care law and their personal health care status, their trust levels of potential messengers for ACA information, and a specific focus on how the rising costs of health care impacts the lives of Latinos in Colorado. In addition to this blog post you can access the slide deck from a recent webinar presentation utilizing this data hosted by Latino Decisions and Adelante con la Salud here.

Clear Need for More/Better Outreach

Overall, the results from this poll indicate that there will need to be not only more outreach to the Latino community regarding the new law, but information that directly targets this population. When asked about their general knowledge regarding the new law, only 13% of Latino adults feel very informed about the ACA (see figure below) compared to a combined 47% who feel either “not all that” or “not that” informed.

ACA Awareness

This is reinforced by an overwhelming majority (69%) of Latino adults in Colorado who say that the ACA is “confusing and complicated” (see figure below) compared to only 22% who feel that they are “well informed.”This perception of the new law is consistent across all sub-groups of the Colorado Hispanic population, including 67% of college graduates from this population who feel that the ACA is “confusing and complicated”.

Perceptions of ACA

When asked to provide the names of different parts of the new law a majority  (54%) of the sample indicated that they “did not know.” The most commonly referenced policies within the ACA were the need to “pay a fine if you don’t have insurance” (19%) and the “mandate” to purchase insurance (18%). As a result, there is a need exists for broad communication on the aspects of the new law that are projected to benefit Latinos in Colorado.

As a final mechanism to assess knowledge of the ACA, we asked respondents to indicate whether they felt undocumented immigrants would be able to purchase private health insurance through the state health exchanges. Only 25% of the sample correctly identified that undocumented immigrants would be “restricted from purchasing insurance through the exchanges”, with 50% believing that they would be able to participate in the exchanges, and another 25% indicating that they did not know. Interestingly, a strong majority (61%) of Latinos in Colorado believe that regardless of how the law is currently structured, undocumented immigrants “should be able to access benefits” through the ACA.

 The Survey Provides Blue-Print For How to Engage Latinos in Colorado About ACA

Based on the results that show a need to provide targeted education and outreach to Latinos in Colorado about the ACA, a major focus of this poll was to query respondents about what messages would be most effective. For example, when asked which language they would like to receive information about the ACA, 59% of respondents indicated a preference for English compared to 14% of respondents who preferred Spanish. However, a large segment (27%) of the Latino population in Colorado prefers to receive information in both languages, including 38% of foreign-born Latinos in Colorado. This suggests that information to Latinos about the ACA will need to be in both English and Spanish with sensitivity to the bilingual nature of the Latino community in Colorado.

Latinos in Colorado also vary in their preference for terminology referring to the new health care law, with 38% preferring “Obamacare,” 29% preferring the “Affordable Care Act” and 14% preferring “Healthcare Reform Program.” There is similar variation among Spanish speakers in Colorado, as 34% of Latino Spanish speakers in Colorado prefer “Reforma de Cuidado de Salud” compared to 20% who prefer “Reforma de Seguro Medico.” Interestingly, the third most popular term for Spanish speakers is “Obamacare,” with 18% indicating that this term has traction for both groups of Latinos in Colorado.

Form of Communication and Most Trusted Messengers

The survey also queried respondents about their preferred form of communication for information about the new health care law. The most commonly identified forms of communication were “Pamphlets and Mailers” with 35% and “Television” and “the Internet” with 30% each.[1] The survey also identified the most trusted individuals and organizations to deliver information about the ACA. The data indicates that the Latino community in Colorado trusts “hospitals” (27%) and “doctors” (21%) as primary messengers; “community centers and organizations” were identified by 17% of the sample. Social networks will also be vital to outreach efforts, as family and friends combined yielded 19% among Latinos in Colorado.

The Rising Costs of Health Care are a Major Burden to Latino Families

The survey also reveals that the costs of health care is creating significant burdens on Latino families and that far too many Latino households in Colorado lack access to health insurance. The survey indicates that 31% of Latinos lacked health insurance at some point in the past 12 months with 24% of the sample indicating that they currently lack health insurance. When queried about the costs of health care nearly half (46%) of Latino adults in Colorado indicate that their health care costs have “gone up” in the past year, 75% of those who have seen their costs rise indicated that this has created a “significant financial burden”.

The costs of health care and medical bills has a tremendous impact on the lives of Latino families in Colorado and on their health seeking behavior. For example, 43% of Latinos in Colorado indicate that they have “used up all or most of their savings” because of medical bills, and another 30% of respondents to the survey said that because of medical bills, they have been unable to “pay for basic necessities like food, housing, and heat.” Indicative of the devastating impact of rising costs of health care, another 39% indicated they have had trouble paying their other bills. Finally, 31% of respondents say that because of the costs, they or a family member have skipped a recommended medical test or treatment.

Financial Burdens

Survey Methodology

Latino Decisions interviewed 401 Latino adults across the state of Colorado between April 11 – 16, 2013 from a list of randomly selected Hispanic Households, and carries a margin of error of +/- 4.9%. Interviews were conducted in English or Spanish, at the discretion of the respondent, and overall, 30% of all interviews were completed in Spanish. Respondents in both landline and cell-phone only households were interviewed by telephone, and respondents were also recruited from an online web panel of Latino adults in Colorado. Overall, the final data were weighted to match the most recent U.S. Census ACS estimates for the Latino population in Colorado, and can be interpreted as reflective of the statewide Latino population. The survey was designed by Drs. Matt A. Barreto and Gabriel R. Sanchez of Latino Decisions, national experts in Latino public opinion and health policy research.


[1] Respondents were able to identify multiple forms of communication which led to totals of greater than 100%.

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