COMMENTARY
It’s No Surprise Why the 2025 Shutdown Fight is Over Healthcare
By Tony Thai
September 30, 2025
Key points: The latest data shows that health care is one of the top priorities for AAPI communities. With millions set to lose coverage in the next several years from provisions in the 2025 reconciliation bill, and with healthcare coverage a major issue in the current shutdown debate, this issue will likely reverberate in the 2026 midterm elections and beyond.
As the threat of a government shutdown looms, health care remains a major and contentious issue among lawmakers. Recent major cuts to Medicaid and the Affordable Care Act (ACA), signed into law as part of the 2025 budget reconciliation package, along with the potential end of the ACA’s enhanced premium tax credits, are expected to bring significant changes to health care in the coming years. Amidst this volatile landscape and the rising costs of medical care, health care is now one of the top concerns for AAPI communities across the country.
In the recent 2025 AAPI Policy Priorities survey, AAPI adults consistently listed health care as one of the biggest problems they face, second only to economic concerns.
Among AAPI adults, 33% listed health care as the biggest problem facing this country today. When asked about the most important problems AAPI adults and their families are currently facing, 41% said that health care was their biggest concern, jumping to the second spot and tied with “Jobs and the economy.”
In addition, 56% of AAPI adults listed health care as the second most difficult item for them and their families to afford right now, coming in behind housing or rent. A large majority of AAPI adults also say they support the government limiting the cost of medication and medical costs, further demonstrating the hardships imposed by rising costs.
This focus on health care represents a shift in priorities for AAPI communities. In the December 2024 AAPI Data/AP NORC survey, only 18% of respondents identified health care reform as a top policy priority, with immigration and foreign policy ranking higher at that time. Now, in the latest survey, 33% of AAPI adults cited health care as their primary concern. This represents a 15 percentage-point jump, underscoring the growing focus on health care issues,especially at a moment when millions are set to lose coverage.
The Congressional Budget Office (CBO) estimates that 10 million people will lose health insurance over the next decade. The total number of uninsured individuals may reach 14 million by 2034, taking into account the expected end of Affordable Care Act premium tax credits, according to the CBO.
States with the largest AAPI populations, such as California, Texas, and New York, are likely to be the most affected by these cuts and potential further cutbacks in the next few years. California (1.7 million), Florida (1.5 million), Texas (1.4 million), and New York (860k) are the states that will have the most people go uninsured due to these health care changes, KFF.org says. In 2025, more than 1 in 3 AAPI adults reported that they are not all confident that they could pay for an unexpected medical expense. Given this data, further cuts to health coverage could have devastating effects on the AAPI community and the ability of AAPI adults to shoulder the costs of medical expenses.
AAPI adults’ opinion on the changes in the reconciliation bill varies depending on the framing of the question. In the 2025 AAPI Policy Priorities Survey, one third of the sample received information about the bill’s tax cut benefits, one third received information about the bill’s costs including cuts to health insurance, and one third received information about both costs and benefits. When respondents were asked about the reconciliation bill’s tax benefits alone, 41% supported and 43% opposed it. Highlighting only health spending cuts and enforcement increases, support fell to 20%, with 75% opposed. Presenting both benefits and cuts, 21% supported the package, while 70% opposed it.
According to Karthick Ramakrishnan, executive director of AAPI Data and an expert in public opinion research, these strong framing effects suggest that AAPI adults don’t have a firm understanding of key provisions in the reconciliation bill, including those related to health care access.
In a separate question, AAPI adults were asked specifically about whether they would support legislation that contained various provisions related to healthcare, mirroring provisions that were in the 2025 reconciliation bill. Only 22 percent supported saving $1 trillion over the next 10 years if it meant cutting Medicaid to low-income people, further underscoring the political potency of health care as an issue for AAPIs even in the context of tax and budget savings.
Finally, in regard to how AAPI adults felt about political parties and health care, 44% said they trust the Democratic Party to lower the cost of health care, compared to 16% believing that the Republican Party would do a better job. However, 33% said they trust neither party to lower health care costs, suggesting room for persuasion in the coming months.
These results, especially the shifting feelings based on the framing of the reconciliation bill questions, demonstrate that AAPI communities are movable on the topic of health care, and that how information is presented to them is crucial in shaping their opinions. Educating AAPI communities on how policy changes will specifically affect them will be crucial as the 2026 midterm elections approach.
The data are clear: health care is one of the top issues for AAPI adults. With key components of the reconciliation bill going into effect over the next two years, it is crucial that lawmakers and advocates engage with AAPI communities and clearly communicate how changes in health care policy will affect AAPIs. And with AAPIs as the fastest-growing electorate in many states across the country, it is just as important that our communities voice their concerns and make their priorities known.
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Tony Thai is a graduate student researcher at AAPI Data and a master’s of public policy student at the UC Berkeley Goldman School of Public Policy. Previously, he was a digital producer at the Seattle Times.