This resource guide is designed to provide key insights and perspectives on the issue of health in Asian American, Native Hawaiian and Pacific Islander communities. 

This guide is part of a larger collection of issue-based resources that highlight key policy insights, data and survey findings that help inform how our diverse AANHPI communities think about, and are affected by, particular issues.

Please check aapidata.com/resource-guides periodically for new resource guides like this one.

Published: December 11, 2025 | Last updated: February 11, 2026


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Key Facts You Need to Know: Health in AANHPI Communities

  1. Health care is personally important to Asian Americans and Pacific Islanders: 41% of AAPI adults cited health care as the most important problem facing them and their family 
  2. Health policy cuts in the 2025 budget reconciliation bill (HR1) are unpopular among AAPIs: 55% of AAPI adults said they would oppose a bill that would save $1 trillion over 10 years by reducing Medicaid for low-income residents. 
  3. AAPIs want more government spending on health care: 70% of AAPI adults believe the government is spending too little on improving the healthcare system.
  4. The proportion of uninsured has declined significantly since the passage of Obamacare, dropping from 16% to 6% among Asian Americans and declining from 17% to 11% among NHPIs. Significant disparities exist among subgroups, with Mongolian (21%) among Asian Americans and Marshallese (21%) having among the highest rates without health insurance.
  5. Most AANHPIs benefiting from HealthCare.gov selected the Silver plan with Cost-Sharing Reductions: 64.5% of AANHPI consumers in 2024 selected this option. Silver plans with CSRs reduce out-of-pocket costs like deductibles and co-payments for income-eligible individuals.
  6. Eleven percent of Asian American adults and 16% of Native Hawaiian and Pacific Islander adults reported fair or poor health. Among Asian Americans, Korean adults (13%) reported the highest rates of poor health.
  7. Approximately 700,000 Asian Americans (4%) and 30,000 Native Hawaiian and Pacific Islander (NHPI) adults (6%) report difficulties with independent living. Bhutanese adults (15%) report the highest proportion among Asian Americans and Fijian (8%) and Native Hawaiian (8%) adults report a slightly higher proportion of independent living difficulties when compared to other NHPI groups.
  8. Approximately 6% of Asian American adults report regular anxiety, a figure that significantly rises to about 15% for Native Hawaiian and Pacific Islander adults.

Insurance Coverage

  • The proportion of uninsured has declined significantly since the passage of the Affordable Care Act, dropping from 16% to 6% among Asian Americans and declining from 17% to 11% among NHPIs.
  • Over 1.1 million Asian Americans (6%) and over 63,000 Native Hawaiians and Pacific Islanders (11%) have no health insurance coverage. 
  • Among Asian Americans, the highest proportion of those without any health insurance coverage include Mongolian (21%), Burmese (11%), and Thai (11%). Conversely, Japanese (97%), Taiwanese (96%), and Indian (96%) have the highest level of health insurance coverage. 
  • Among NHPIs, the highest proportion of those without any health insurance coverage include Marshallese (21%), Tongan (17%), and Samoan (10%). Those with the highest level of health insurance coverage include Native Hawaiian (8%) and Fijian (8%).

2024 Marketplace Open Enrollment Plan Selections

  • Of the approximately 1 million Asian-American, Native Hawaiian, and Pacific Islander (AANHPI) consumers enrolling through HealthCare.gov in 2024, the most popular choice was the Silver plan with Cost-Sharing Reductions (CSRs), selected by 64.5% of enrollees. Silver plans with CSRs help reduce the costs you have to pay when you get care, like deductibles and copayments, for people who qualify based on their income.
  • The next most common selection, chosen by 20.8% of AANHPI consumers, was the Bronze plan. These plans generally have the lowest monthly premium but typically require you to pay a very high deductible, meaning you pay more of your medical costs yourself before the insurance company starts paying.
  • Fewer consumers selected Gold plans, at 12.5%. Gold plans generally have a higher monthly premium than Silver or Bronze, but you usually pay less when you actually receive medical care, such as having a lower deductible and lower copayments.
  • The least common option was Silver plans without CSRs, representing only 2.2% of plan selections for this group.

General Health

  • Over the past five years, Asian American adults have the lowest reports of fair or poor health status, while Native Hawaiians and Pacific Islanders have shown an increase in their report of fair or poor health status. Most recently (2022-2024), approximately 11% of Asian American adults and 16% of Native Hawaiian and Pacific Islander adults reported fair or poor health status.        
  • Among Asian Americans, Korean (13%), Other Asian (12%), and Vietnamese (12%) report the highest levels of fair or poor health status, whereas Asian Indian (8%) and Chinese (10%) report the lowest levels of fair or poor health status.

Chronic Conditions

Any Type of Cancer

  • Asian American adults report among the lowest percentage of any type of cancer over the past five years. Most recently (2022-2024), approximately 4% of Asian American adults reported any type of cancer.      
  • Among Asian American adults,  Japanese (7%), Chinese(6%), and Filipino American adults (5%) are most likely to have ever received a cancer diagnosis between 2022-2024.

High Cholesterol

  • Over the past five years, Asian American adults have maintained the 2nd highest percentage for high cholesterol, while Native Hawaiian and Pacific Islanders have seen their percentage of high cholesterol decrease over the past few years. Most recently (2022-2024), approximately 23% of Asian American adults and 17% of Native Hawaiian and Pacific Islander adults report high cholesterol.        
  • Among Asian American adults, Filipino Americans (28%), followed by Vietnamese Americans (25%) and Japanese (25%) have the highest percentage of high cholesterol.

Diagnosed Hypertension

  • Over the past five years, the percentage of Asian American adults and Native Hawaiian and Pacific Islanders diagnosed with hypertension has been similar, with the most recent reports (2022-2024) showing approximately 22% of Asian American adults and Native Hawaiian and Pacific Islander adults reporting high cholesterol.     
  • Among Asian Americans, Filipino Americans are disproportionately more likely to have been diagnosed with hypertension (32%), followed by Japanese Americans (27%).

Diagnosed Diabetes

  • Over the past five years, the percentage of Asian American adults diagnosed with diabetes has steadily increased while the percentage of Native Hawaiian and Pacific Islander adults diagnosed with diabetes has been decreasing since 2020. Recent reports (2022-2024) show approximately 11% of Asian American adults and 10% Native Hawaiian and Pacific Islander adults have been diagnosed with diabetes. 
  • Among Asian Americans, Filipino Americans have the highest proportion of diagnosed diabetes (14%), and Chinese Americans have the lowest proportion of diagnosed diabetes (7%) in 2022-2024.

Disability Status

Ambulatory Disability

  • Over 700,000 Asian Americans (4%) and over 36,000 NHPI adults (7%) report having ambulatory difficulties, which can include difficulty walking, climbing stairs, reaching, lifting, or carrying.
  • Among Asian Americans, Bhutanese (11%) and Japanese adults (7%) report the highest proportion of ambulatory difficulties, while Mongolian (1%), Taiwanese (2%) adults have the lowest share of ambulatory difficulties.  
  • Among NHPI, Fijian (9%) and Native Hawaiian (8%) adults have the highest share of ambulatory difficulties.

Cognitive Disability

  • Over 500,000 Asian Americans (3%) and over 30,500 NHPI adults (6%) report having cognitive difficulties (e.g.., learning, remembering, concentrating) that relate to a physical, mental or emotional condition. 
  • Among Asian American adults, Bhutanese adults (12%) reported the highest proportion of cognitive difficulties, while Malaysian and Taiwanese adults (2%) have among the lowest share of cognitive difficulties. 
  • Among NHPI adults, Native Hawaiian (7%) adults have the highest share of cognitive difficulties, and Fijian adults (2%) report the lowest proportion of cognitive difficulties.

Independent Living Disability

  • Over 700,000 Asian Americans (4%) and over 30,000 NHPI adults (6%) report having independent living difficulties that make it difficult or impossible to perform basic activities outside the home alone.
  • Among Asian American adults, Bhutanese adults (15%) reported the highest proportion of independent living difficulties, while Malaysian and Mongolian adults (2%) have among the lowest share of independent living difficulties. 
  • Among NHPI adults the proportion of independent living difficulties was similar across groups, with Fijian (8%) and Native Hawaiian (8%) reporting a slightly higher proportion.

Self-Care Disability

  • By race: Over 300,000 Asian Americans (2%) and nearly 17,000 NHPI adults (3%) report having self-care difficulties that make it challenging for them to take care of their own personal needs such as bathing, dressing, or getting around inside the home.
  • By ethnicity AA: Among Asian American adults, Bhutanese adults (10%) reported the highest proportion of self-care difficulties, while Mongolian (, Malaysian and Taiwanese adults (2%) have among the lowest share of self-care difficulties. 
  • By ethnicity PI: Among NHPI adults, Native Hawaiian (7%) adults have the highest share of cognitive difficulties, and Fijian adults (2%) report the lowest proportion of cognitive difficulties.

Vision Disability

  • By race: Almost 300,000 Asian Americans (2%) and over 16,000 NHPI adults (3%) report having vision difficulties, which can mean being blind or having serious difficulty seeing even with corrective lenses.
  • By ethnicity AA: Among Asian American adults, Bhutanese adults (5%) reported the highest proportion of vision difficulties, and Taiwanese (1%) and Asian Indian (1%) reported the lowest share of vision difficulties.
  • By ethnicity PI: Among NHPI adults, Native Hawaiian (7%) adults have the highest share of vision difficulties, and Fijian adults (2%) report the lowest proportion of cognitive difficulties.

Hearing Disability

  • By race: Over 400,000 Asian Americans (2%) and over 18,000 NHPI adults (4%) report having hearing difficulties, which includes those who are deaf or have serious difficulties hearing. 
  • By ethnicity AA: Among Asian American adults, Bhutanese (6%) and Japanese adults (5%) reported the highest proportion of hearing difficulties compared to all other Asian American subgroups.
  • By ethnicity PI: Among NHPI adults, Native Hawaiian (5%) and Guamanian or Chamorro (4%) have a slightly higher share of hearing difficulties compared to other NHPI adults

Mental Health

Depression

  • Over the past 5 years, Asian American adults have consistently reported the lowest percentage (2%) of regular feelings of depression across all major racial groups. 
  • Among Asian Americans in 2022-2024, Korean American (4%) and Vietnamese American (3%) adults report the highest percentages of depressive feelings, while Asian Indian (1%) and Chinese American adults (2%) report the lowest percentage of depressive feelings.

Anxiety

  • Asian American adults reported the lowest percentage of regular feelings of worry, nervousness, or anxiety while Native Hawaiian and Pacific Islanders reported the second highest percentage. Recent reports (2022-2024) show approximately 6% of Asian American adults and 15% Native Hawaiian and Pacific Islander adults report regular feelings of worry, nervousness, or anxiety.
  • In 2022-2024, Japanese, Korean, and Other Asian American adults had the highest percentage of adults reporting regular feelings of worry, nervousness, and anxiety. Vietnamese and Asian Indian Americans had the lowest percentage of adults reporting regular feelings of worry, nervousness, or anxiety.

Mental Health Counseling

  • Although there has been a steady increase in mental health service utilization over the past five years, the percentage of adults that have received mental health counseling in the past 12 months has remained the lowest (5-7%) among Asian American adults. Until recently, Native Hawaiian and Pacific Islanders also saw a steady increase in their mental health service utilization, with the 2nd highest percentage of usage (14%) from 2021-2023.
  • Among Asian Americans, mental health service utilization between 2022-2024 was especially low among Vietnamese American adults (4%), and highest among Korean American adults (13%) and Japanese American adults (11%).


AANHPI Views on Healthcare

  • AAPI households earning under $50,000 are more likely than those earning $100,000 or more to be extremely or very worried about not being able to access health care (54% vs. 31%) and about losing or not having health insurance (49% vs. 27%). (January 2026 AAPI Data | AP-NORC Poll)

  • AAPI Democrats are more likely than AAPI Republicans to be extremely or very concerned about increased health care costs (65% vs. 42%) and lack of access to health care (42% vs. 26%). (January 2026 AAPI Data | AP-NORC Poll)
  • Concerns about health care costs are prevalent. Nearly all AAPI adults are at least somewhat concerned about an increase in the cost of their health care. (January 2026 AAPI Data | AP-NORC Poll)

  • AAPI adults largely trust doctors (74%) and nurses (72%) to act in their best interest, similar to the general population. And regarding the high cost of healthcare in the U.S., most AAPI adults hold pharmaceutical companies (77%) and private health insurers (73%) responsible. (March 2025 AAPI Data | AP-NORC Poll)

Views on Healthcare Policy

  • Health policy cuts in the 2025 budget reconciliation bill (HR1) are unpopular among AAPIs: 55% of AAPI adults said they would oppose a bill that would save $1 trillion over 10 years by reducing Medicaid for low-income residents, demonstrating a lack of support for health care cuts even if it means overall cost savings to taxpayers. (2025 AAPI Policy Priorities Survey)

  • Most AAPI adults support government regulations that ensure affordable health care. 84% support the government placing limits on the cost of medication and 82% support the government placing limits on the cost of medical care. (2025 AAPI Policy Priorities Survey)


Key Programs

Medicare

What is it?

  • Health insurance for seniors and people with disabilities, since they are uniquely vulnerable to health problems.
  • Before Medicare, about half of American seniors lacked health insurance – now, almost all are insured.

How it works

  • Part A hospital insurance (emergency insurance, funded by payroll taxes)
  • Part B supplementary medical insurance (more general insurance, funded by premiums)
    • Premiums generally deducted straight from your SS benefit 
  • Part C medicare advantage (voucher for private plan)
  • Part D prescription drugs (funded by premiums / cost sharing

Who is eligible for the program?

  • Parts A and B: people eligible for SS
    • Generally, people age 65 and older are eligible for Medicare. One rule of thumb is that anyone who is eligible for Social Security Old Age, Survivors, and Disability Insurance (OASDI) is eligible for Medicare. They or their spouse must have worked for at least a decade in the U.S. Younger people with disabilities are also eligible for Medicare after they have received Social Security Disability Insurance for 24 months. This waiting period does not apply to people with end-stage renal disease or ALS.
  • Must be a citizen or lawful resident
    • There is no citizenship requirement to access Medicare. However, immigrants are less likely to have worked in the U.S. for a decade, limiting access. To address this disparity, green card holders are allowed to waive the work history requirement after five years of continuous residence in the U.S. 
  • Undocumented workers with Individual Tax Identification Numbers (ITINs) pay Medicare taxes 
    • Undocumented immigrants are not eligible for Medicare. However, many undocumented workers fund benefits through their payroll taxes. In 2022, workers without Social Security Numbers paid $6.4 billion in Medicare taxes, or nearly 1.5% of all Medicare taxes paid. 

Medicaid

What is it?

Medicaid is a health insurance program targeted to lower-income recipients that is financed jointly by the federal government and the states. States have a great deal of flexibility in designing and administering their programs, and thus, Medicaid eligibility and benefits can and often do vary widely from state to state.

Who administers SSI?

The Centers for Medicare & Medicaid Services (CMS) at the Department of Health and Human Services (HHS) is responsible for Medicaid program administration at the federal level, but individual state Medicaid agencies establish many policies and manage their own programs on a day-to-day basis.

Who is eligible for the program?

In order to receive federal funding, states must cover certain “mandatory” populations:

  • children through age 18 in families with income below 138 percent of the federal poverty line ($36,777 for a family of three in 2025);
  • people who are pregnant and have income below 138 percent of the poverty line;
  • certain parents or caretakers with very low income; and
  • most seniors and people with disabilities who receive cash assistance through the Supplemental Security Income (SSI) program.

States may also receive federal funds to cover “optional” populations:

  • people in the “mandatory” groups listed above whose income exceeds the limits for coverage; 
  • seniors and people with disabilities not receiving SSI and with income below the poverty line; 
  • “medically needy” people (those whose income exceeds the state’s regular Medicaid eligibility limit but who have high medical expenses, such as for nursing home care, that reduce their disposable income below the eligibility limit) and other people with higher income who need long-term services and supports; 
  • non-disabled adults with income below 138 percent of the poverty line, including those without children (due to the Affordable Care ACT).
  • In the ten states that have not implemented ACA Medicaid expansion, adults over 21 are generally ineligible for Medicaid unless they are pregnant, caring for children, elderly, or have a disability

Affordable Care Act (ACA)

What is it?

  • A streamlined, standardized way to directly purchase health insurance if you don’t have access to affordable public or employer insurance
  • Premium Tax Credits subsidize this insurance, limiting the cost to a set % of your income

How it works

States either run their own exchanges or participate in healthcare.gov. Free market within each state determines which plans are offered.

If eligible, insurance purchase through an exchange is subsidized through the Premium Tax Credit

  • Refundable tax credit, paid monthly (based on projected income, then reconciled when file return) or annually
  • PTCs are sized to cap your premiums for a basic (silver) health insurance plan at a set share of your income. In 2026, max percentage will increase from 8.5% to 9.96%, while min increases from $0 to 2.1% of income for families at FPL.

Who is eligible for the program?

Undocumented people are not eligible to buy insurance through the exchanges or receive PTCs. People can only enroll in marketplace plans after a qualifying life event (i.e. changing jobs, aging out of a parent’s insurance, getting married, moving) or during Open Enrollment Season (every fall).

To be eligible for PTCS, you must:

  • File a tax return
  • Have AGI >= 100% Federal Poverty Level (FPL)
    • In Medicaid expansion states, 138% FPL because can’t be eligible for Medicaid 
    • Starting for 2026, must also have AGI < 400% FPL
  • Not be undocumented

Supplemental Security Income (SSI)

What is it?

SSI, or Supplemental Security Income, is a Federal income supplement program designed to help persons who are aged, blind, or have other disabilities, who have little or no income. It provides cash to meet basic needs for food, clothing, and shelter.

Who administers SSI?

The Social Security Administration (SSA) administers SSI.

Who is eligible for the program?

To get SSI, you must be at least 65 years old, blind, or have a disability, and have “limited” income and resources.

In addition, one must be either a U.S. citizen or national, or a noncitizen in one of the certain alien classifications granted by the Department of Homeland Security (DHS);

  • reside in one of the 50 States, the District of Columbia, or the Northern Mariana Islands; and
  • not be absent from the U.S. for a full calendar month or 30 or more consecutive days.

SNAP

What is it?

SNAP (formerly known as the Food Stamp Program) is the nation’s largest nutrition assistance program. SNAP provides food benefits for working families with low-paying jobs, low-income older adults (60 years and older) and people with disabilities living on fixed incomes, and other individuals and households with low incomes.

Who administers SNAP?

SNAP is administered by the U.S. Department of Agriculture (USDA) in cooperation with state social service agencies.

Who is eligible for the program?

Only U.S. citizens and certain lawfully present non-citizens may receive SNAP benefits. SNAP is not and has never been available to undocumented non-citizens.

Who is not eligible for the program?

Individuals who are on strike, all people without a documented immigration status, some students attending college more than half time, certain immigrants with lawful immigration statuses, and certain people with drug-related felony convictions in some states.

What is the Three-Month Time Limit?

Individuals aged 18 or over and under 50 have been limited to three months of SNAP benefits every three years unless they are working or in a work or training program at least 20 hours a week. Some individuals are exempt from this work-reporting requirement (sometimes referred to as a time limit), such as those who live with children in the household, those determined to be physically or mentally unfit for work, pregnant people, and others.

What are notable changes to the program? 

  • In April 2009, as part of the American Recovery and Reinvestment Act, a 13.6 percent increase was added to the TFP for most households (about $80 for a family of four) in an effort to help invigorate the economy and in recognition of the economic challenges faced by program participants.
  • On April 1, 2020, a nationwide SNAP work requirement suspension took effect due to the COVID-19 pandemic. This public health emergency ended on May 11, 2023, and the first countable month toward the time limit was July 2023.
  • In June 2023, the Fiscal Responsibility Act was enacted that phased in an expansion of the work-reporting requirement to adults up to age 54 beginning in October 2024. The agreement also provided exemptions from the work-reporting requirement for veterans, people experiencing homelessness, and former foster youth up to age 24. States will need to identify these individuals for them to be exempt. The changes imposed by the Fiscal Responsibility Act will expire on September 30, 2030.
  • On March 9, 2024, President Biden signed into law the Consolidated Appropriations Act, 2024, which provides that Compacts of Free Association (COFA) citizens of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau who lawfully reside in the United States are eligible for certain federal public benefit programs, including SNAP. COFA citizens are not subject to a waiting period and are immediately eligible for benefits as long as they meet all other SNAP financial and non-financial eligibility requirements.

WIC

What is it?

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a public health nutrition program providing nutrition education, nutritious foods, breastfeeding support, and healthcare referrals for income-eligible women who are pregnant or post-partum, infants, and children up to age 5.

Who administers WIC?

WIC is under the jurisdiction of the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS). State Agencies run programs in their jurisdictions.

Who is eligible for the program?

Category: Pregnant, recently pregnant, and breastfeeding women, infants and children under 5 years old are eligible for WIC benefits. Caregivers including dads, grandparents and foster parents may apply for children under five in their care.

Income: applicants’ gross income (i.e., before taxes are withheld) must fall at or below 185 percent of the federal poverty line. State income must fall between 100 percent and 185 percent of federal poverty guidelines, though most states use the maximum guideline. This is approximately $49,000 annually for a family of three in the contiguous U.S. An applicant who already receives Supplemental Nutrition Assistance Program benefits (SNAP, formerly food stamps), Medicaid, or monthly Temporary Assistance for Needy Families cash assistance payments is automatically considered income-eligible for WIC, even if the program’s income limit is above 185 percent of poverty.

Residential: Must be a resident of the state to which they are applying for assistance.

Nutrition risk: Must have a nutritional risk assessment by a qualified health professional (physician, nurse, or nutritionist).

Disability Insurance

What is it?

SSDI is part of what we think of as traditional social security – people pay in as they work, then are able to claim benefits if they become disabled

  • It is only available to people who are unable to work “substantial gainful activity”, though people can return to work for a 9 month trial run without losing benefits, or do limited work for three years
  • Average benefit in 2024 was $1,538, about half of workers’ pre-disability earnings

SSI is a “last resort” benefit for extremely low-income people with severe disabilities

  • You must be both low-income and have very little in assets
    • Meant for people who can’t work – over half of SSI beneficiaries don’t have any other source of income
  • People age 65+ don’t need a disability to get SSI
  • Because it doesn’t have a work requirement, children are eligible for SSI
  • Benefits are small, max $967 ($1,450 for a couple)

How it works

SSDI benefits, eligibility, and funding are completely federal

  • Funded through payroll taxes (note tax max) and DI trust fund
  • You must have worked 5 years in the last decade andd at least ¼ of your adult life to qualify

SSI has strict rules set mostly by the federal government, but states have some flexibility

  • Funded by general revenues, but still an entitlement
  • Asset limit of $2,000 ($3k if married)
  • CNMI is the only territory with SSI
    • Guam, PR, USVI get a block grant to fund similar but smaller benefits with stricter eligibility criteria
    • American Samoa has nothing similar
  • States can offer SSI supplements, administered either by the state, SSA, or both
    • Some states offer additional supplements for kidsSSA is chronically underfunded, reducing their ability to serve beneficiaries

SSA is chronically underfunded, reducing their ability to serve beneficiaries

  • In addition, administrative burden for SSI in particular is high
  • State agencies with federal funding (DDS’s) determine if someone is disabled under the criteria for each program
    • SSA field offices handle all other aspects of eligibility etc.


Other Resources

Community Partners

National

State and Local

California

Georgia

Hawaii

Illinois

New York

Oregon

Pennsylvania

Texas

Virginia

Washington

Note: this is not an exhaustive list and will be continuously updated.


Suggested citation:  Michele Wong, Karthick Ramakrishnan, Katie Windham, and Jamie Noh, “By the Numbers: AAPIs and Health. AAPI Data Guide on Timely Policy Issues.” Berkeley, CA: AAPI Data, 2025.

  1. AAPI Data, Associated Press and NORC at the University of Chicago. (2025, May 21). May 2025 AAPI Data | Associated Press-NORC Survey of AAPI Adults. https://aapidata.com/surveys/aapidata-ap-norc-survey-april-may-2025
  2. AAPI Data, Associated Press and NORC at the University of Chicago. (2025, March 12). March 2025 AAPI Data | Associated Press-NORC Survey of AAPI Adults. https://aapidata.com/surveys/aapi-data-ap-norc-survey-feb-march-2025
  3. AAPI Data, NCAPA. (2025, January 15). Policy Priorities Survey. https://aapidata.com/surveys/2025-aapi-policy-priorities-survey
  4. AAPI Data (2025). AANHPI Community Data Explorer via https://explore.aapidata.com. Results are based on AAPI Data’s analysis of American Community Survey 2023 Five-Year Public Use Microdata Sample (PUMS) via iPUMS USA. https://usa.ipums.org/usa/ 
  5. National Center for Health Statistics. Percentage of fair or poor health status for adults aged 18 and over, United States, 2019-2021—2022-2024. National Health Interview Survey. Generated interactively: Dec 10 2025 from https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html
  6. Warrier A, Lee A, Peters C, De Lew N, Buchmueller T. HealthCare.gov Plan Selections by Race and Ethnicity, 2015-2024. (Issue Brief No. HP-2024-19). Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. October 2024. Accessed at: https://aspe.hhs.gov/reports/marketplace-plan-selection-race-ethnicity2015-2024