01 May Priced Out: How the Insurance System Is Failing AAPI Americans
Every May, we celebrate the rich heritage of Asian American and Pacific Islander communities — their cultures, stories, sacrifices, and contributions that have shaped this nation in ways that far too often go overlooked. But during this time of appreciation, we must also confront a troubling reality: for millions of AAPI Americans, a broken insurance system is turning manageable chronic conditions into life-threatening emergencies.
There is meaningful progress to acknowledge. Advocates have fought hard for language access, community health workers, and culturally competent care, producing real improvements in health outcomes for many AAPI individuals. Efforts to expand disaggregated data collection have also advanced, ensuring that the distinct needs of individual communities are not obscured by broad categorization. Each of these gains represents an essential step toward improving health outcomes. But none of them can compensate for the cost of coverage that continues to put affordable care out of reach for far too many AAPI families.
The evidence is stark. In America, 37%, 35%, 33%, and 28% of Mongolian, Burmese, Bhutanese, and Hmong Americans respectively live below the poverty line. Yet average employer-sponsored family health coverage now costs more than $26,000 annually. As premiums continue to rise, these communities are systematically priced out of coverage, forced to delay or forgo routine care until manageable conditions become crises.
The consequences are predictable and devastating. Native Hawaiian and Pacific Islander individuals die from diabetes at more than twice the national average. Asian-origin populations face elevated risks of type 2 diabetes and cardiovascular disease at lower BMI thresholds than current screening guidelines recognize, meaning high-risk patients are routinely missed and left without timely intervention or access to medication.
Mental health coverage gaps compound this crisis. AAPI individuals seek mental health care at lower rates than any other racial or ethnic group. Cultural stigma plays a role, but so does coverage that is inadequate, out-of-network, and unaffordable. When mental health benefits exist on paper but are financially inaccessible in practice, they are not real benefits at all.
Congress has the tools to address each of these failures. First, lawmakers must reform benefit design and rein in Pharmacy Benefit Manager (PBM) practices that drive up premiums and out-of-pocket costs, so that AAPI families are not priced out of coverage. Second, officials must enforce Mental Health Parity and Addiction Equity Act requirements, so that insurers cannot treat behavioral health as a secondary tier of coverage. Third, legislators must direct the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) to update clinical screening criteria to reflect specific AAPI risk profiles, moving away from a one-size-fits-all approach so that high-risk patients receive preventive care rather than emergency intervention.
AAPI Heritage Month is a time to honor communities that have given so much to this country. To truly show that appreciation, we must ensure that every AAPI family can access the coverage they need to live long, healthy lives. Congress has the tools. What is required now is the will to use them.