It wasn't the Latin rhythms pulsating from the parking lot at Congreso Education & Training Center in North Philadelphia that caught Carmen Rosa's attention.

Nor was it the bright bunches of balloons at the Latino group's Health Care Fair on Oct. 25.

What attracted Rosa, 61, was the prospect of health insurance under the Affordable Care Act.

A Congreso staffer saw Rosa walking by on her way home from work and stopped her to ask if she had health insurance. Rosa, who works part time, said no. So the staffer invited her in to learn more.

"She is very interested in receiving health insurance," said Lesly Jimenez, a behavioral health case manager who translated for Rosa. "She has been here [in the U.S.] legally for three years and has been uninsured the entire time."

About 80 percent of the 14,000 people Congreso serves in the city's Latino community are covered by Medicaid, said Waleska Maldonado, Congreso's senior vice president of health services. But many of the remaining 20 percent, like Rosa, work jobs with no insurance or can't afford the premiums for an individual plan. They are the prime target of Congreso's efforts.

"I expect half [of the 20 percent] to go on the exchange," Maldonado said. The remaining 10 percent "will fall between the cracks. We need Medicaid to be expanded as soon as possible."

Pennsylvania is still negotiating with federal officials over whether to expand Medicaid. So Congreso, a Federally Qualified Health Center, will continue providing basic care to people who are ineligible for the online marketplace and Medicaid. But such clinics don't offer specialists, and up to 60 percent of Congreso's clients suffer chronic illnesses such as asthma, heart disease, and diabetes, along with a high incidence of HIV-AIDS. "People are treating their chronic illnesses in the emergency room," she said.

Congreso now has six certified application counselors and a certified navigator.

Enthusiasm has been building. On Oct. 1, the day the marketplace opened, Congreso received 25 inquiries. The next day, 100 people called. Interest has grown so much that the staff has created a spreadsheet for appointments.

"We have a lot of people who don't understand databases," Maldonado said. "They know the Internet, but not how to enroll. Many of our clients won't do this on their own."

It's no surprise that Congreso has yet to enroll anyone via the website. And the Spanish-language site has been delayed. Still, no one is concerned that the delays will dampen the community's enthusiasm for the ACA.

"The community feels that the ACA is awesome, and people want to know more about it," said Samantha Rivera, Congreso's manager of development. "It's not losing momentum on the community level. The people who need it the most aren't affected by the slow start."

Perhaps even more important, interest among young people in the community remains strong, especially among those in college, Maldonado said.

Congreso wants people to realize when they enroll that they should know more about a plan than the monthly premium. They need to consider federal subsidies as well as deductibles, hospital and doctor networks, and drug plans.

The numbers coming from the Oct. 25 fair were disappointing. Roughly 50 people attended, many of whom took home ACA literature. Twelve signed up for an appointment with a counselor.

One of those was Rosa, who had heard about the marketplace on the news and from a coworker. But she had no idea where to get more information or how to enroll.

Now she did.

"She is happy that Congreso is doing this for the community," Jimenez translated.

Rosa, sitting next to the young Congreso worker, smiled and nodded her head in agreement.





Resources for Human Development 855-668-9536.



The Health Federation of Philadelphia 215-567-8001

Mental Health Association of Southeastern Pennsylvania


New Jersey

Center for Family Services Inc. 1-877-9ACCESS (1-877-922-2377)