"Demand is high, but systems aren't meeting that demand," said Daniel Zingale, a senior vice president at the California Endowment. "There are three points of entry: online, in person or over the phone, and there has been instability in all three."

Katie Murphy, supervising attorney with Neighborhood Legal Services of Los Angeles County, said October and November were "lost months" with so few enrollment counselors available.

"Many of the certified enrollment counselors, the boots on the ground, have only been certified in the last couple of weeks," Murphy said. "Groups where there's a language issue or trust issues with the government will need the people in their communities to help them."

Covered California's website has been available in Spanish since enrollment launched in October. But patient advocates say that didn't help some Latinos who don't have online access or prefer reading over something on paper with their family.

The state exchange said a paper application in Spanish should be available next week. It attributed the long delay to getting government approvals and feedback from outside groups.

The lack of a paper application in Spanish is huge, said Sonya Vasquez, policy director for the Community Health Councils in Los Angeles. "There's definitely a digital divide when it comes to going online and applying for things," she said.

Covered California will need to attract plenty of Latinos if it hopes to reach its goal of enrolling 500,000 to 700,000 people in subsidized health insurance by March 31. Through Dec. 7, the state has enrolled 156,143 people in private health plans, and most of them are receiving federal subsidies.

The state estimates that 1.2 million Latinos should qualify for subsidies, which could help alleviate concerns about expensive premiums.

In California, Latinos are among the strongest supporters of the Affordable Care Act. A USC Dornsife/Los Angeles Times poll published last month showed that nearly two-thirds of Latinos in the state backed the law, compared with 50% approval among registered voters overall.

State Sen. Ed Hernandez (D-West Covina), chairman of the Senate Health Committee, said the exchange has a compelling sales pitch to Latinos.

"These enrollment numbers aren't even close to where they need to be," Hernandez said. "The state of California has to fix that."


Twitter: @chadterhune


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