ARLINGTON, Texas _ Bich-Thu "Lisa" Pham has become a familiar face at this Vietnamese community center, setting out her Affordable Care Act insurance materials in a small office several afternoons each week. She also holds enrollment sessions at local Vietnamese shopping centers and near Vietnamese-owned nail salons, and every Sunday morning she assists members of her own Vietnamese congregation in Fort Worth who want to sign up for coverage.
She's a "rock star" in her ability to get Vietnamese residents in the greater Fort Worth area insured, said Daniel Bouton, who directs health services at Community Council of Greater Dallas, the nonprofit organization that receives federal funding to assist northeast-central Texas consumers sign up for ACA coverage.
It's an important mission in Texas, where the Vietnamese uninsured rate runs nearly twice the national rate. Dallas-Fort Worth is home to the fourth-largest Vietnamese population in the U.S., with nearly 72,000 residents, and the Houston area ranks third, with nearly 104,000 residents, according to a Census Bureau analysis of 2010 data.
Nationally, 7.7 percent of Vietnamese residents were uninsured as of 2016 versus nearly 20 percent in 2010 prior to the ACA, according to an analysis of Census Bureau data by the Asian & Pacific Islander American Health Forum, a nonprofit advocacy organization. (Among all Americans, the uninsured rate last year was 8.8 percent.)
But the rate among Vietnamese Texans is 14.2 percent, although that is a steep drop from 27.4 percent in 2010.
In California, which has the nation's two largest metropolitan Vietnamese communities, the rate was 16.6 percent in 2010 and 4.2 percent last year.
Along with sometimes limited English-speaking proficiency, signing up Vietnamese-Americans can involve other challenges, including in some cases a lack of credit history, said Cathy Phan, who has worked on ACA enrollment in the Houston area for the Asian American Health Coalition-Hope Clinic. Part of the ACA's verification process includes running a check with a credit reporting agency, she said.
"We see that a lot _ especially with newly immigrated Vietnamese community members," Phan said. "Over in Vietnam, everybody still uses cash. I think the general cultural mentality is you don't really want to go into debt _ you want to avoid it as much as possible."
