Manhattan, KS

Census Place

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2019 Population

55,290

0.359% 1-year decline

US Senator

Jerry Moran

Republican Party

US Senator

Roger Marshall

Republican Party

2019 Median Age

24.5

0.407% 1-year decrease

2019 Poverty Rate

26.3%

3.77% 1-year increase

2019 Median Household Income

$50,537

2.55% 1-year growth

2019 Median Property Value

$209,700

4.64% 1-year growth

2019 Employed Population

29,631

0.757% 1-year decline

About

In 2019, Manhattan, KS had a population of 55.3k people with a median age of 24.5 and a median household income of $50,537. Between 2018 and 2019 the population of Manhattan, KS declined from 55,489 to 55,290, a −0.359% decrease and its median household income grew from $49,279 to $50,537, a 2.55% increase.

The 5 largest ethnic groups in Manhattan, KS are White (Non-Hispanic) (76.9%), Black or African American (Non-Hispanic) (5.79%), Asian (Non-Hispanic) (5.77%), White (Hispanic) (4.68%), and Two+ (Non-Hispanic) (3.86%). 0% of the households in Manhattan, KS speak a non-English language at home as their primary language.

93% of the residents in Manhattan, KS are U.S. citizens.

The largest universities in Manhattan, KS are Kansas State University (5,855 degrees awarded in 2019), Manhattan Area Technical College (390 degrees), and Bellus Academy (121 degrees).

In 2019, the median property value in Manhattan, KS was $209,700, and the homeownership rate was 39%. Most people in Manhattan, KS drove alone to work, and the average commute time was 13.7 minutes. The average car ownership in Manhattan, KS was 2 cars per household.

United States Kansas Pottawatomie County, KS Riley County, KS Manhattan, KS Manhattan City PUMA, KS

Diversity

Manhattan, KS is home to a population of 55.3k people, from which 93% are citizens. As of 2019, 9.24% of Manhattan, KS residents were born outside of the country (5.11k people).

In 2019, there were 13.3 times more White (Non-Hispanic) residents (42.5k people) in Manhattan, KS than any other race or ethnicity. There were 3.2k Black or African American (Non-Hispanic) and 3.19k Asian (Non-Hispanic) residents, the second and third most common ethnic groups.

Race and Ethnicity

The 3 largest ethnic groups in Manhattan, KS

White (Non-Hispanic)
42.5k ± 529
Black or African American (Non-Hispanic)
3.2k ± 382
Asian (Non-Hispanic)
3.19k ± 271

7.08%

Hispanic Population

3.92k people

7.08% of the people in Manhattan, KS are hispanic (3.92k people).

The following chart shows the 7 races represented in Manhattan, KS as a share of the total population.

Heritage

Foreign-Born Population

9.24%

2019 Foreign-Born Population

5.11k people

10.2%

2018 Foreign-Born Population

5.67k people

As of 2019, 9.24% of Manhattan, KS residents (5.11k people) were born outside of the United States, which is lower than the national average of 13.7%. In 2018, the percentage of foreign-born citizens in Manhattan, KS was 10.2%, meaning that the rate has been decreasing.

The following chart shows the percentage of foreign-born residents in Manhattan, KS compared to that of it's neighboring and parent geographies.

Age by Nativity

Median Native-Born Age

± 0.3

Median Foreign-Born Age

± 1.2

In 2019, the median age of all people in Manhattan, KS was 24.5. Native-born citizens, with a median age of 24, were generally younger than foreign-born citizens, with a median age of 30. But people in Manhattan, KS are getting getting younger. In 2018, the average age of all Manhattan, KS residents was 25.

Global Diversity

The PUMS dataset is not available at the Place level, so we are showing data for Kansas.

Most Common Origin

Mexico
84,130 ± 7,017 people
India
14,053 ± 2,903 people
Vietnam
10,675 ± 2,532 people

In 2019, the most common birthplace for the foreign-born residents of Kansas was Mexico, the natal country of 84,130 Kansas residents, followed by India with 14,053 and Vietnam with 10,675.

Citizenship

93%

2019 Citizenship

92.2%

2018 Citizenship

As of 2019, 93% of Manhattan, KS residents were US citizens, which is lower than the national average of 93.4%. In 2018, the percentage of US citizens in Manhattan, KS was 92.2%, meaning that the rate of citizenship has been increasing.

The following chart shows US citizenship percentages in Manhattan, KS compared to that of it's neighboring and parent geographies.

Military

Veterans

Most Common Service Period

Gulf War (2001-)
2,023 ± 394
Vietnam
572 ± 161
Gulf War (1990s)
310 ± 117

Manhattan, KS has a large population of military personnel who served in Gulf War (2001-), 3.54 times greater than any other conflict.

COVID-19

Daily New Cases by Date

Showing data at the state level for Kansas. Hospitalization data for some states may be delayed or not reported.

Y-Axis

This chart shows the number of COVID-19 daily new cases by date in Kansas, as a 7-day rolling average, compared with the four states with the most similar number of confirmed cases.

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Unemployment Insurance Claims

Data is only available at the state level. Showing data for Kansas.

This chart shows weekly unemployment insurance claims in Kansas (not-seasonally adjusted) compared with the four states with the most similar impact.

The most recent data point uses Advance State Claims data, which can be revised in subsequent weeks.

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Employment by Industry Sector

Data is only available at the state level. Showing data for Kansas.

Y-Axis

8.45%

Year-over-year growth

Employment change between May 2020 and May 2021

As of May 2021, there are 145M people employed in Kansas. This represents a 8.45% increase in employment when compared to May 2020.

The following chart shows monthly employment numbers for each industry sector in Kansas.

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Community Mobility

Data is only available at the state level. Showing data for Kansas.

This chart presents movement trends over time in the state of Kansas across different categories of places such as retail and recreation, groceries and pharmacies, parks, transit stations, workplaces, and residential.

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Economy

Median household income in Manhattan, KS is $50,537. In 2019, the place with the highest median household income in Manhattan, KS was Census Tract 13.02 with a value of $78,246, followed by Census Tract 13.01 and Census Tract 1, with respective values of $77,674 and $74,857.

Males in Kansas have an average income that is 1.41 times higher than the average income of females, which is $45,721. The income inequality in Kansas (measured using the Gini index) is 0.458, which is lower than than the national average.

The economy of Manhattan, KS employs 29.6k people. The largest industries in Manhattan, KS are Educational Services (8,264 people), Retail Trade (3,654 people), and Accommodation & Food Services (3,267 people), and the highest paying industries are Utilities ($47,880), Public Administration ($44,464), and Professional, Scientific, & Technical Services ($39,196).

Wages

Median Household Income

$50,537

2019 value

± $2,508

2.55%

1 Year Growth

± 7.69%

Households in Manhattan, KS have a median annual income of $50,537, which is less than the median annual income of $65,712 across the entire United States. This is in comparison to a median income of $49,279 in 2018, which represents a 2.55% annual growth.

The following chart shows how the median household income in Manhattan, KS compares to that of its neighboring and parent geographies.

Wage by Gender in Common Jobs

The PUMS dataset is not available at the Place level, so we are showing data for Kansas.

$64,354

Average Male Salary in Kansas

± $1,958

$45,721

Average Female Salary in Kansas

± $1,400

In 2019, full-time male employees in Kansas made 1.41 times more than female employees.

This chart shows the gender-based wage disparity in the 5 most common occupations in Kansas by number of full-time employees.

Wage by Race and Ethnicity in Common Jobs

The PUMS dataset is not available at the Place level, so we are showing data for Kansas.

Highest Average Salaries by Race & Ethnicity in Kansas

Native Hawaiian and Other Pacific Islander
$56,139 ± $74,364
Asian
$52,393 ± $7,262
White
$49,769 ± $1,226

In 2019 the highest paid race/ethnicity of Kansas workers was Native Hawaiian and Other Pacific Islander. These workers were paid 1.07 times more than Asian workers, who made the second highest salary of any race/ethnicity in Kansas.

This chart shows the race- and ethnicity-based wage disparities in the 5 most common occupations in Kansas by number of full-time employees.

Wage Distribution

The closest comparable wage GINI for Manhattan, KS is from Kansas.

0.458

2019 Wage GINI in Kansas

0.46

2018 Wage GINI in Kansas

In 2019, the income inequality in Kansas was 0.458 according to the GINI calculation of the wage distribution. Income inequality had a 0.47% decline from 2018 to 2019, which means that wage distribution grew somewhat more even. The GINI for Kansas was lower than than the national average of 0.478. In other words, wages are distributed more evenly in Kansas in comparison to the national average.

This chart shows the number of workers in Kansas across various wage buckets compared to the national average.

Income by Location

Use the dropdown to filter by race/ethnicity.

Race/Ethnicity

Highest Median Household Income (Total)

Census Tract 13.02
Census Tract 13.01
Census Tract 1

In 2019, the place with the highest Median Household Income (Total) in Manhattan, KS was Census Tract 13.02 with a value of $78,246, followed by Census Tract 13.01 and Census Tract 1, with respective values of $77,674 and $74,857.

The following map shows all of the places in Manhattan, KS colored by their Median Household Income (Total).

Poverty by Age and Gender

Females 18 - 24

Largest Demographic Living in Poverty

26.3% of the population for whom poverty status is determined in Manhattan, KS (13k out of 49.3k people) live below the poverty line, a number that is higher than the national average of 12.3%. The largest demographic living in poverty are Females 18 - 24, followed by Males 18 - 24 and then Females 25 - 34.

The Census Bureau uses a set of money income thresholds that vary by family size and composition to determine who classifies as impoverished. If a family's total income is less than the family's threshold than that family and every individual in it is considered to be living in poverty.

Poverty by Race and Ethnicity

Largest Race or Ethnicity Living in Poverty

White
9,796 ± 672
Hispanic
1,276 ± 358
Asian
1,020 ± 229

The most common racial or ethnic group living below the poverty line in Manhattan, KS is White, followed by Hispanic and Asian.

Occupations

Employment by Occupations

29.6k

2019 Value

± 1,326

−0.757%

1 Year decline

± 6.41%

From 2018 to 2019, employment in Manhattan, KS declined at a rate of −0.757%, from 29.9k employees to 29.6k employees.

The most common job groups, by number of people living in Manhattan, KS, are Education Instruction, & Library Occupations (4,186 people), Office & Administrative Support Occupations (3,315 people), and Sales & Related Occupations (2,903 people). This chart illustrates the share breakdown of the primary jobs held by residents of Manhattan, KS.

Most Common

The most common jobs held by residents of Manhattan, KS, by number of employees, are Education Instruction, & Library Occupations (4,186 people), Office & Administrative Support Occupations (3,315 people), and Sales & Related Occupations (2,903 people).

Most Specialized

Compared to other places, Manhattan, KS has an unusually high number of residents working as Life, Physical, & Social Science Occupations (2.51 times higher than expected), Education Instruction, & Library Occupations (2.33 times), and Food Preparation & Serving Related Occupations (1.55 times).

Highest Paid

The highest paid jobs held by residents of Manhattan, KS, by median earnings, are Health Diagnosing & Treating Practitioners & Other Technical Occupations ($62,850), Management Occupations ($57,344), and Management, Business, & Financial Occupations ($52,547).

Industries

Employment by Industries

29.6k

2019 Value

± 1,326

−0.757%

1 Year decline

± 6.41%

From 2018 to 2019, employment in Manhattan, KS declined at a rate of −0.757%, from 29.9k employees to 29.6k employees.

The most common employment sectors for those who live in Manhattan, KS, are Educational Services (8,264 people), Retail Trade (3,654 people), and Accommodation & Food Services (3,267 people). This chart shows the share breakdown of the primary industries for residents of Manhattan, KS, though some of these residents may live in Manhattan, KS and work somewhere else. Census data is tagged to a residential address, not a work address.

Most Common

The most common industries in Manhattan, KS, by number of employees, are Educational Services (8,264 people), Retail Trade (3,654 people), and Accommodation & Food Services (3,267 people).

Most Specialized

Compared to other places, Manhattan, KS has an unusually high number of Educational Services (3.01 times higher than expected), Accommodation & Food Services (1.46 times), and Retail Trade (1.1 times) industries.

Highest Paying

The highest paying industries in Manhattan, KS, by median earnings, are Utilities ($47,880), Public Administration ($44,464), and Professional, Scientific, & Technical Services ($39,196).

Domestic Trade

Domestic Production & Consumption

Domestic production and consumption consists of products and services shipped from Kansas to other states, or from other states to Kansas.

Top Domestic Production in Dollars

In 2018, the top outbound Kansas product (by dollars) was Cereal grains with $30.4B, followed by Mixed freight ($30B) and Coal-n.e.c. ($20.2B).

The following chart shows the share of these products in relation to all outbound Kansas products.

Domestic Trade Growth

Showing data for Kansas.

$263B

2018 Value in Kansas

$404B

Projected 2045 Value in Kansas

53.5% growth

In 2018, total outbound Kansas trade was $263B. This is expected to increase 53.5% to $404B by 2045.

The following chart shows how the domestic outbound Kansas trade is projected to change in comparison to its neighboring states.

Interstate Trade

Interstate trade consists of products and services shipped from Kansas to other states, or from other states to Kansas.

Most Common Trade Partners

Missouri
$25.9B
Texas
$23.5B
Nebraska
$17.9B

In 2018, the top outbound Kansas domestic partner for goods and services (by dollars) was Missouri with $25.9B, followed by Texas with $23.5B and Nebraska and $17.9B.

The following map shows the amount of trade that Kansas shares with each state (excluding itself).

Civics

In the 2016 presidential election, the popular vote in Riley County, KS went to Donald J. Trump with 46.9% of the vote. The runner-up was Hillary Rodham Clinton (43.4%), followed by Other (9.68%). The most partisan county was Wallace County, KS with 90.4% of the vote going to Donald J. Trump running for the Republican Party.

Jerry Moran and Roger Marshall are the senators currently representing the state of Kansas. In the United States, senators are elected to 6-year terms with the terms for individual senators staggered.

Kansas is currently represented by 4 members in the U.S. house, and members of the House of Representives are elected to 2-year terms.

Presidential Popular Vote Over Time

Voting results are not available for Manhattan, KS. Showing the available data for Riley County, KS.

Showing data up to the 2016 election. Updated election results are currently being processed, and will be released in the coming months.

2016 Election Results

Donald J. Trump (46.9%)
Republican Party
Hillary Rodham Clinton (43.4%)
Democratic Party
Other (9.68%)
Other Party

In the 2016 presidential election, the popular vote in Kansas went to Donald J. Trump with 46.9% of the vote. The runner-up was Hillary Rodham Clinton (43.4%), followed by Other (9.68%).

The following chart shows the popular vote results in Kansas for each registered party from 1976 to 2016.

Presidential Popular Vote by County

Presidential voting results are only available at the county level. Showing data for the counties inside of Kansas.

Showing data up to the 2016 election. Updated election results are currently being processed, and will be released in the coming months.

Donald J. Trump

Popular Vote for Riley County, KS

46.9% for the Republican Party

Most Partisan Counties in Kansas

Wallace County, KS
90.4% for Donald J. Trump (Republican Party)
Sheridan County, KS
87.1% for Donald J. Trump (Republican Party)
Gove County, KS
84.9% for Donald J. Trump (Republican Party)

In the 2016 presidential election, the most partisan county in Kansas was Wallace County, KS with 90.4% of the vote going to Donald J. Trump running for the Republican Party.

The following map shows the counties in Kansas colored by their party leaning.

US Senators from Kansas

Senatorial voting results are only available at the state level. Showing data for Kansas.

Jerry Moran

Senator from Kansas

Assumed office on January 3, 2011

Roger Marshall

Senator from Kansas

Assumed office on January 3, 2021

Jerry Moran and Roger Marshall are the senators currently representing Kansas.

In the United States, senators are elected to 6-year terms with the terms for individual senators staggered.

The following chart shows elected senators in Kansas over time, excluding special elections, colored by their political party.

US Representatives from Kansas

Kansas is currently represented by 4 members in the U.S. house.

Members of the House of Representives are elected to 2-year terms, and the following chart shows the how the members for Kansas have changed over time starting in 2008.

Education

In 2019, universities in Manhattan, KS awarded 6,423 degrees. The student population of Manhattan, KS is skewed towards women, with 11,365 male students and 11,619 female students.

Most students graduating from Universities in Manhattan, KS are White (4,891 and 81.5%), followed by Hispanic or Latino (373 and 6.22%), Two or More Races (228 and 3.8%), and Black or African American (220 and 3.67%).

The largest universities in Manhattan, KS by number of degrees awarded are Kansas State University (5,855 and 91.2%), Manhattan Area Technical College (390 and 6.07%), and Bellus Academy (121 and 1.88%).

The most popular majors in Manhattan, KS are Elementary Education & Teaching (266 and 4.14%), General Animal Sciences (223 and 3.47%), and General Business Administration & Management (215 and 3.35%).

The median tuition costs in Manhattan, KS are $15,950 for private four year colleges, and $9,735 and $25,251 respectively, for public four year colleges for in-state students and out-of-state students.

Concentrations

Most Common

Mechanical Engineering
165 degree-majorss awarded
General Animal Sciences
204 degree-majorss awarded
General Marketing & Marketing Management
183 degree-majorss awarded

In 2019, the most common concentation for Bachelors Degree recipients in Manhattan, KS was Mechanical Engineering with 165 degrees awarded.

This visualization illustrates the percentage of students graduating with a Bachelors Degree from schools in Manhattan, KS according to their major.

Universities

Largest Universities by degrees awarded

Kansas State University
5,855 degrees awarded
Manhattan Area Technical College
390 degrees awarded
Bellus Academy
121 degrees awarded

$9,735

Median In-State Public

$15,950

Median Private

In 2019, the Manhattan, KS institution with the largest number of graduating students was Kansas State University with 5,855 degrees awarded.

Student Gender for Common Institutions

3,079

Degrees Awarded to Men

3,344

Degrees Awarded to Women

In 2019, 3,079 men were awarded degrees from institutions in Manhattan, KS, which is 0.921 times less than the 3,344 female students who received degrees in the same year.

This chart displays the gender disparity between the institutions in Manhattan, KS by degrees awarded.

Student Race and Ethnicity

Most Common Student Race or Ethnicity

White
4,891 degrees awarded
Hispanic or Latino
373 degrees awarded
Two or More Races
228 degrees awarded

In 2019 the most common race/ethnicity group awarded degrees at institutions in Manhattan, KS was White students. These 4,891 degrees mean that there were 13.1 times more degrees awarded to White students then the next closest race/ethnicity group, Hispanic or Latino, with 373 degrees awarded.

Housing & Living

The median property value in Manhattan, KS was $209,700 in 2019, which is 0.872 times smaller than the national average of $240,500. Between 2018 and 2019 the median property value increased from $200,400 to $209,700, a 4.64% increase. The homeownership rate in Manhattan, KS is 39%, which is lower than the national average of 64.1%. People in Manhattan, KS have an average commute time of 13.7 minutes, and they drove alone to work. Car ownership in Manhattan, KS is approximately the same as the national average, with an average of 2 cars per household.

Housing

Property Value

$209,700

2019 Median

± $7,430

$200,400

2018 Median

± $6,938

In 2019, the median property value in Manhattan, KS grew to to $209,700 from the previous year's value of $200,400.

The following charts display, first, the property values in Manhattan, KS compared to it's parent and neighbor geographies and, second, owner-occupied housing units distributed between a series of property value buckets compared to the national averages for each bucket. In Manhattan, KS the largest share of households have a property value in the $200k - $250k range.

Household Income

Please note that the buckets used in this visualization were not evenly distributed by ACS when publishing the data.

$50,537

Median Household Income

± $2,508

20.3k

Number of Households

± 976

In 2019, the median household income of the 20.3k households in Manhattan, KS grew to $50,537 from the previous year's value of $49,279.

The following chart displays the households in Manhattan, KS distributed between a series of income buckets compared to the national averages for each bucket. The largest share of households have an income in the < $10k range.

Property Taxes

$3k+

Average Range

This chart shows the households in Manhattan, KS distributed between a series of property tax buckets compared to the national averages for each bucket. In Manhattan, KS the largest share of households pay taxes in the $3k+ range.

Rent vs Own

39%

2019 Homeownership

38.7%

2018 Homeownership

In 2019, 39% of the housing units in Manhattan, KS were occupied by their owner. This percentage grew from the previous year's rate of 38.7%.

This percentage of owner-occupation is lower than the national average of 64.1%. This chart shows the ownership percentage in Manhattan, KS compared it's parent and neighboring geographies.

Commute Time

13.7 minutes

Average Travel Time

Using averages, employees in Manhattan, KS have a shorter commute time (13.7 minutes) than the normal US worker (25.5 minutes). Additionally, 0.614% of the workforce in Manhattan, KS have "super commutes" in excess of 90 minutes.

The chart below shows how the median household income in Manhattan, KS compares to that of it's neighboring and parent geographies.

Commuter Transportation

Most Common Commute in 2019

Drove Alone (72.8%)
Walked (9.27%)
Carpooled (9.19%)

In 2019, 72.8% of workers in Manhattan, KS drove alone to work, followed by those who walked to work (9.27%) and those who carpooled to work (9.19%).

The following chart shows the number of households using each mode of transportation over time, using a logarithmic scale on the y-axis to help better show variations in the smaller means of commuting.

Transportation

Car Ownership

2 cars

Average Number

The following chart displays the households in Manhattan, KS distributed between a series of car ownership buckets compared to the national averages for each bucket. The largest share of households in Manhattan, KS have 2 cars, followed by false.

Health

94.4% of the population of Manhattan, KS has health coverage, with 55.8% on employee plans, 6.85% on Medicaid, 5.49% on Medicare, 20.7% on non-group plans, and 5.52% on military or VA plans.

Per capita personal health care spending in Kansas was $7,651 in 2014. This is a 2.99% increase from the previous year ($7,429).

Primary care physicians in Riley County, KS see 1474 patients per year on average, which represents a 1.38% increase from the previous year (1454 patients). Compare this to dentists who see 1614 patients per year, and mental health providers who see 419 patients per year.

Comparing across all counties in the state, Elk County has the highest prevalence of diabetes (22.5%). Additionally, Osage County has the highest prevalence of adult obesity (42.4%)

Patient to Clinician Ratios

Data is only available at the country level. Showing data for Riley County, KS.

1,474 to 1

Patient to Primary Care Physician Ratio in Riley County, KS

Primary care physicians in Riley County, KS see an average of 1,474 patients per year. This represents a 1.38% increase from the previous year (1,454 patients).

The following chart shows how the number of patients seen by primary care physicians has been changing over time in Riley County, KS in comparison to its neighboring geographies.

Behavioral Health Conditions

Data only available at the state level.

State with the Highest Prevalence

West Virginia
8.26% of the population affected
Arkansas
8.13% of the population affected
New Hampshire
7.98% of the population affected

In 2016, West Virginia had the highest prevalence of adults with major depressive episode, with 8.26% of the population affected. The second highest is Arkansas (8.13%), followed by New Hampshire (7.98%).

The following map shows the percent of individuals with major depressive episode by state over multiple years.

Social Needs

Data only available at the state level.

Most prevalent states

California
35,798 individuals
New York
5,087 individuals
Florida
4,915 individuals

In 2017, California had the highest estimated number of chronically homeless individuals in the nation, at 35,798. New York has the second highest (5,087), followed by Florida (4,915).

The following map shows the estimated number of chronically homeless individuals by state over multiple years.

Access and Quality

Data only available at state level.

Most prevalent states

Mississippi
19.2% of adults
Texas
17.9% of adults
Louisiana
17.6% of adults

In 2016, Mississippi had the highest prevalence of adults who haven't seen a doctor in the past 12 months due to cost, at 19.2%. It is followed by Texas (17.9%) and Louisiana (17.6%).

The following map shows the prevalence of adults who haven't seen a doctor in the past 12 months due to cost by state over multiple years.

Health Care Spending

Data is only available at the state level. Showing data for Kansas.

$7,651

Total Per Capita Spending on Personal Health Care in Kansas

$4,855

Per Enrollee Private Health Insurance Spending on Personal Health Care

$6,736

Per Enrollee Medicaid Spending on Personal Health Care

$10,126

Per Enrollee Medicare Spending on Personal Health Care

Between 2013 and 2014, all personal health care spending per capita in Kansas (including private, Medicare, and Medicaid) grew 2.99%, from $7,429 to $7,651.

The following chart shows how this spending changed over time in comparison to Medicaid, Medicare, and private insurance spending, per enrollee.

Health Care Coverage

5.64%

Uninsured

55.8%

Employer Coverage

6.85%

Medicaid

5.49%

Medicare

20.7%

Non-Group

5.52%

Military or VA

Between 2018 and 2019, the percent of uninsured citizens in Manhattan, KS declined by 1.08% from 5.7% to 5.64%.

The following chart shows how the percent of uninsured individuals in Manhattan, KS changed over time compared with the percent of individuals enrolled in various types of health insurance.