Health organizations around the country are making the final push to enroll about 10 percent of the population that remains uninsured by Jan. 31, and in Southwest Colorado, local officials face their own set of challenges.

“President Obama highlighted 18 million people gained health coverage (from the Affordable Care Act), and we know there have been declines in the uninsured,” said Rachel Klein, director of organizational strategy for Families USA, in a news conference last week.

“But there are still millions of people who remain uninsured,” she said.

Health officials point to specific reasons why some remain without health coverage, but cost and the perception families can’t afford another bill stand out as the main reasons.

Mike Perry, a partner in PerryUndem Research/Communication, said a study after the second enrollment period ended in February 2015 showed most uninsured valued health coverage, but they lacked information about options.

“There’s a perception they can’t afford it,” Perry said. “I say perception, because it’s less based on actually going to the marketplace. It’s not really based on factual knowledge around affordability.”

That disconnect is easily explained when you look at the remaining uninsured, said Mirna Castro, director of health navigation and promotions for Servicios de La Raza in Colorado.

“We’re very fearful about the huge number of Latinos uninsured,” Castro said.

In Colorado, Hispanic residents, which account for 20 percent of the state’s population, have an uninsured rate of 37.6 percent. The main reason for those “definitely high” numbers, Castro said, is a language barrier.

“It was going to be imperative we utilize Latino media in Colorado to get the word out,” Castro said of Health Navigation’s recent initiatives to reach the underserved community. “It was imperative we met them where they work, live, pray and play.”

The same can be said for the remaining uninsured in Southwest Colorado. Latinos account for 33.8 percent of La Plata County residents but are the majority of the 10 percent who remain uninsured.

And whereas health officials along the Front Range can use media, health organizations in Southwest Colorado cannot.

“Southwest Colorado doesn’t have a Spanish-speaking newspaper or radio station that would make it really easy to reach a large number of people in the Spanish-speaking population,” said Kevin O’Connor, a health coverage guide with San Juan Basin Health Department.

“So there are certain populations that are difficult to reach,” he said.

Instead, local health officials have taken to other means.

O’Connor said the health department has an outreach program for Spanish-speaking residents, which serves underserved populations of all kinds in an effort to educate people about different health coverage options and hold open enrollment events.

The department also distributes fliers in Spanish, visits businesses that are likely to employ underserved populations, and even goes door-to-door.

San Juan Basin also works with the La Plata Family Centers Coalition, among other local groups.

“More than 90 percent of our population has health coverage, but that remaining 10 percent remains to be a diverse group,” O’Connor said. “And I even consider the so-called young invincibles that are relatively low-income and under 30 to be a part of that.”

The penalty for those who do not insure is the greater of two amounts, either a 2.5 percentage of income or a specified dollar amount, which hits $695 in 2016.

“The fine penalty turned out to be the second reason people signed up,” Perry said. “The increasing fine is making a difference, particularly in young people.”

Members of Colorado HealthOP, the state nonprofit insurance cooperative that was discontinued at the end of 2015, have until Feb. 29 to enroll.

jromeo@durangoherald.com