Unlike other states, California allows young people who were granted deportation deferrals by the Obama administration to sign up for Medicaid. State Senator Ricardo Lara is expected to introduce legislation this week that would allow immigrants living here illegally to sign up for the exchange and receive state subsidies.

Image At the AltaMed Resource Center, the pamphlets are in Spanish. State officials are trying to expand efforts to market the new health care law. Credit... Monica Almeida/The New York Times

Even among those living here legally, there is fear that receiving Medicaid or insurance subsidy will jeopardize their chance at citizenship by labeling them a “public charge,” a term used to refer to immigrants dependent on the government, experts say. The Obama administration has issued guidelines assuring immigrants that receiving medical assistance will not affect their immigration eligibility, but many health care officials say the guidelines have done little to quell fears and confusion.

Latinos now make up nearly 50 percent of the overall population in California. Covered California officials and other outside experts have projected that Latinos should account for at least one-third of all those who sign up for coverage through the exchange. California is the only state to release enrollment numbers by ethnicity.

Marisa Nuñez first heard about the health care exchange from her daughter’s teacher at school, and she was eager to find a counselor to help answer her questions. But after a week of making calls and being placed on hold for nearly an hour, Ms. Nuñez gave up. Only her daughter’s complaints about stomach pains for several days prompted Ms. Nuñez to try again, when she discovered she would not be eligible to purchase insurance through Covered California, because she immigrated here illegally.

“There is nowhere I can go for help for me, which is scary,” Ms. Nuñez said. Although her oldest daughter, who came with her from Mexico a decade ago, is also barred from assistance, her two youngest children, both born in the United States, most likely qualify for Medicaid, an option she is exploring. “I still do not know what my children can get or not,” she said. “I want the same thing as everybody else: a place for them to be able to go when they are sick.”

For those like Ms. Nuñez who have relied on walk-in clinics, cost is also a deterrent. Amanda Aguirre, the president of the Regional Center for Border Health in Yuma, Ariz., said many Latinos there felt the private plans available through the exchange were too expensive, even if they qualified for federal subsidies.