While Latino enrollment has lagged in California's insurance marketplace, Asian-Americans and legal Asian immigrants have signed up on Covered California in numbers outstripping their representation in the pool of eligible people.
According to the latest data from the exchange, the overwhelming majority of people of Asian descent are enrolling are doing so through certified insurance agents, as opposed to community groups or the Covered California website.
There is no charge to consumers who work with agents, whose commissions are paid by insurance companies.
People of Asian descent make up about 14 percent of eligible people in California, according to estimates compiled by the UCLA Center for Health Policy Research and the University of California, Berkeley's Labor Center. They reached that target straight out of the gate, making up 13.5 percent of all enrollees by January.
They have surged from there. In the most recent data from Covered California, which comprised enrollment from Oct. 1 to Feb. 28, people of Asian heritage made up 22.9 percent of all enrollees.
Licensed insurance brokers can sell customers plans on the Covered California marketplace, but they must first be certified to do so. Covered California says 40 percent of its total Covered California enrollments are coming via these certified insurance agents. But Covered California says that within certain Asian-American groups, the percentage of enrollments through agents is much higher:
- 57 percent for Chinese-Americans
- 65 percent of Vietnamese-Americans
- 70 percent of Korean-Americans
These numbers "suggest that the Asian agents are a driving force in helping Covered CA exceed our enrollment goal in Asian communities," Wendy McAnelly, a public information officer for Covered California, said in an email.
This information wasn't a big surprise to Simon Chew. He runs Ehealth-Plans, an insurance business with four offices in San Francisco. All his agents are trilingual, speaking English, Mandarin and Cantonese.
Chew estimates he's signed up 2,000 people since the Covered California marketplace opened last October, and half of them were uninsured.
He sees a difference between how Caucasians shop and how his clients — overwhelmingly Chinese-Americans and Chinese immigrants — shop. While what he calls the "mainstream market" is comfortable shopping online, people of Chinese descent want to do business in person, with someone of a similar background.
"That's how, culturally, Asians do business," Chew said. "They like to stick to their own kind because of communication convenience." Too much Covered California advertising is focused on the website, Chew says, as opposed to letting people know that their local insurance agents could also help them.
Covered California didn't have enrollment information broken down by type for Latinos, who make up nearly half of the marketplace's pool of potential buyers but have so far accounted for just 22 percent of all enrollments. Covered California has been faulted for its missteps in signing up Latinos.
But Asians aren't a monolithic group, advocates say.
Community groups have long worried that those with limited-English skills would be left out of Covered California. Doreena Wong, with Advancing Justice in Los Angeles, is concerned that certain immigrant groups who have less experience with insurance or universal health care in their home countries would be harder to reach. "The united Cambodian community, Indian, Pakistani," she said, "We don't know what the numbers are for those particular subgroups."
Yeri Shon, of the Korean Community Center of the East Bay in Oakland, said her group has had great success in signing up the monolingual clients she serves. There's universal health care in Korea, so people are already comfortable with the concept of the government helping out.
But she said in regular conference calls with other community groups, she's heard from advocates who say they are having a harder time. "The Tongan community leader says teaching the idea of insurance is very difficult," Shon said. "In Tonga, people apparently only go to the hospital when they are really sick."
This story is part of a partnership with NPR, KQED and Kaiser Health News.