Private health insurance coverage and out-of-pocket premiums among pre-retirement aged individuals from six largest Asian subgroups in the U.S

Objective: With the implement of the Affordable Care Act, it becomes more important to understand private health insurance status and the financial burden among pre-retirement aged individuals who are not yet covered by Medicare. This study examined this topic by comparing six sub-ethnic groups of Asian Americans in the U.S., whose heterogeneity is often overlooked with the aggregated data that represent the whole Asian group. 

Methods: The 2007-2011 National Health Interview Study data were analyzed for 4,628 Asian Americans (ages 50-64), including 697 Asian Indians, 1,125 Chinese, 1,393 Filipinos, 434 Japanese, 524 Koreans, and 455 Vietnamese. Non-Hispanic White individuals were included as a comparison group (n=19,236). The STATA SVY procedures were used to account for the complex sampling design.

Results: Overall, 67.9% of pre-retirement aged Asian Americans had private health insurance, while the rates varied from 55.4% among Koreans to 83.8% among Japanese. Among non-Hispanic Whites, 78.4% had private insurance. Among those with private insurance, 8.6% of Asians and 7.3% of non-Hispanic Whites individually purchased their coverage, not through their employment. However, the rates also ranged from 4.0% among Filipinos to 21.5% among Koreans. In terms of the annual out-of-pocket premiums, while Asian American ($4,093, in 2011 dollars) and non-Hispanic Whites ($4,058) paid similar amounts, there were significant subgroup differences - from $3,253 among Vietnamese to $4,876 among Asian Indians.

Conclusion: This study demonstrates the importance of examining within-group heterogeneity among Asian Americans in the U.S. in terms of their access to and the burden of private health insurance coverage.