We have had almost weekly calls with very senior people in the administration to talk about what our strategy has been, what's working. Covered California dotcom is a project of Covered California and the California Department of Health Care Services. That means if there's a tough decision, [the DHCS chief] and I can make it and we can move on. We have very good command and control. One thing that's challenging the federal government is that it does not have those processes.
What makes you so optimistic?
We're seeing enrollment increasing every day. It's about what people are telling their friends, neighbors and families.
Literally, for millions of Californians, this is an answer to a prayer. I think it's transformative.
You've been criticized for being too rosy.
I don't think we are. The facts are 2.6 million Californians are going to get a federal subsidy to help with their plans. The facts are 1.4 million are newly eligible for Medi-Cal. The facts are, no one can be turned away. I don't call that rosy, I call that "Dragnet" — just the facts, ma'am.
Are you really able to handle the demand you want to generate?
Absolutely. We're adding people to take calls. More important, [more] enrollment is going to be happening in communities [with in-person advisors; the federal program calls them navigators.] Go to "find help near you" [online] and put in a ZIP Code and find certified enrollment counselors. We always anticipated that 80% of the enrollment would be with the human touch. Health insurance is confusing, especially if you've never had it before, so in-person assistance is vital. And we feel good about our cadre of partners in every community in the state.
Your father and uncle — California physicians — fought for Medicare in the 1960s. Did you grow up understanding the effect of insurance on healthcare?
When I really got a sense of that was in the early days of the AIDS epidemic. In the early '80s, when I was 25, I did not feel young and immortal. I was seeing my friends dying and being denied healthcare coverage day after day. We talk about "young immortals" — if you're a man of my age, when we were 25, we did not feel immortal. We felt lucky to be alive.
What are the demographics for Covered California so far?
I expected what I call one-touch people, people who have preexisting conditions: You tell them once [coverage will be available] and they flock to get insurance. I was surprised and encouraged [by] people between 21 and 30; their [numbers are] very close to the percentage in the population.
But there are very few Latinos.
We're doing huge marketing. We've got billboards in East L.A.; we've got big buys with Univision and Telemundo and Spanish-language radio. [Those] low numbers didn't really surprise us because most enrollment that first month was not [in person] in communities. We now have thousands of certified enrollment counselors to help people; 60% speak Spanish. We had focus groups who worked with Spanish-speaking applications; we've done an end-to-end refresh of [the application]. I'm very confident the rates of Spanish-speaking applicants will go up dramatically.
Colorado launched some humorous ads in dubious taste targeted at young immortals.
We may change, but we have not gone the humor route, even for young immortals. Our market testing [found], yeah, that's kind of funny, but health insurance is a really serious matter.
One of our ads shows a young parent looking in the back seat at the kids in his car after he drives by an auto accident. Another shows a mountain biker going head over heels and ending up in the hospital. Young immortals aren't going to be roped into getting coverage; they're going to say, "You know, I am a spill over my handlebars away from being $20,000 in debt."
This interview was edited and excerpted from taped transcripts.