On Wednesday, Covered California, the state’s public health exchange, plans to end coverage for thousands of Bay Area residents who didn’t submit timely documents proving that they’re legal residents of the state.

More than a quarter of the termination notices—or roughly 27,000 letters about the impending cutoff—went to Bay Area families out of the 98,000 notices sent statewide in early September. But in the East Bay, immigration specialists say language barriers and email glitches may complicate this week’s deadline, and local safety net clinics are bracing for a possible influx of newly-disenfranchised patients.

It’s a challenge to reach everyone, especially non-English speakers, said Tanya Broder, senior attorney with the National Immigration Law Center in Oakland. “Some people received these letters and thought it was spam, or they didn’t understand the consequences,” she said.

There may be glitches in the system which make it difficult for immigration status documents to be processed, Broder said. “Most of the people who received letters actually are eligible, and many of them did submit correct documents,” Broder said. “We don’t want to see consumers punished for errors or delays in the system for which they have no control.”

Brighter Beginnings Family Health Clinic, a safety net clinic in Richmond, saw a decrease in patients after some signed up for coverage through Covered California. But if consumers lose their health insurance, “we would get a higher influx of patients trying to access our services,” said Drea Riquelme, Brighter Beginnings’ clinic site administrator. The clinic serves mostly uninsured patients and has only limited slots for patients, she said.

Since the letters were sent out, roughly half of all problem cases have since been resolved, said Wendy McAnelly, Covered California’s information officer.

“We need documents that show that you are lawfully present in the United States as a U.S. citizen, U.S. national, or an individual with eligible immigration status to continue your health insurance through Covered California,” the Covered California letter read. “You may have already sent documents, but we could not check citizenship or immigration status using the documents we received from you.”

Enrollees don’t have to submit residency verification before their health insurance policy can begin, but they must submit it to continue to receive health insurance.

Covered California is reaching out to many communities directly to ensure that the letters are received and acted upon to avoid termination of health insurance. “We sent out the lawful presence letter on September 2, and then we also did a follow-up email to everybody,” McAnelly said. “Then last week we sent out another wave of reminders.”

McAnelly said she’s unaware of any system errors related to the processing of these documents. “I know that during the enrollment process our website had some issues handling the volume,” she said, “but as far as verification of residency, I haven’t heard any issues that I’m aware of.”

The electronic enrollment system is a benefit of having an exchange, said Danice Cook, HealthPAC administrator with Alameda County Health Care Services Agency. “Our clinics have seen clients come in with that form and are helping them complete it,” said Cook, referencing Covered California’s letter to consumers.

Consumers have until Tuesday (September 30) to submit verification documents to Covered California, either by fax to 1-888-329-3700, or online at coveredcalifornia.com.

In these final days, Covered California is continuing to push to get the word out.

“If they can’t provide verification by September 30, these consumers run the risk of losing their coverage,” said McAnelly. In addition, if consumers are receiving federal subsidies to help pay for their insurance premiums, they may be on the hook to pay that back to the federal government.