The average American spends just under $13,000 on health coverage yearly (a nearly $3,000 increase from 2020). But, the coverage received varies greatly depending on where you live.
The cost of health insurance in the U.S. varies from state to state and is affected by federal subsidies and the number of insurance companies. These differences affect the services available and your out-of-pocket expenses. The future of healthcare is uncertain as single-payer healthcare gains traction, and it is unknown if the Affordable Care Act will be upheld or repealed.
Despite the high cost of healthcare in the US, it does not necessarily lead to better outcomes. Research by the Kaiser Family Foundation has found that the US falls behind other developed countries’ health coverage, life expectancy, and disease burden. However, the US has made progress in increasing healthcare access for individuals in poor health and slowing the growth of healthcare costs.
To determine where Americans receive the best and worst health care, Impactful used data from a WalletHub analysis that compared and ranked all 50 states and the District of Columbia based on cost, accessibility, and outcome.
The analysis considered factors such as average monthly premiums, the cost of a medical visit, and the cost of a dental visit to determine the cost. Access was evaluated based on the number of emergency responders, the percentage of insured adults, the average emergency room wait time, and other accessibility factors. The ranking of medical outcomes was based on factors such as life expectancy, infant, child, and maternal mortality rates, heart disease rates, and other outcomes. The state’s cost, access, and outcomes scores were used to determine its overall score.
WalletHub used a 40-metric weighted system to evaluate each state’s score in cost, access, and outcomes on a 100-point scale. A score of 100 indicated the best healthcare value.
The 10 best and 10 worst states for healthcare are listed below.
Best States for Healthcare
1. Rhode Island
- Healthcare score: 65.12
- Cost rank: 3
- Access rank: 3
- Outcomes rank: 11
Rhode Island has achieved its lowest-ever uninsured rate, with just 2.9% of residents without insurance. Little Rhody also has one of the lowest infant mortality rates in the nation. The Families First Coronavirus Response Act (FFCRA) also paused Medicaid redeterminations for two years, allowing recipients to maintain their no-cost health coverage.
2. Massachusetts
- Healthcare score: 65.03
- Cost rank: 26
- Access rank: 1
- Outcomes rank: 1
With a health-insured rate of over 97%, Massachusetts has some of the most accessible insurance in the US. The state possesses an impressively low preventable death rate and actively looks into and addresses issues of racial and economic equity in its healthcare programs.
3. Hawaii
- Healthcare score: 63.30
- Cost rank: 11
- Access rank: 14
- Outcomes rank: 3
At 5% for adults and 2.5% for children, Hawaii is far ahead of the national average with its low uninsured rates. The Aloha State keeps on the lower end for both infant mortality rates and healthcare costs as well as sitting at an impressive #4 for lowest preventable death rates.
4. Minnesota
- Healthcare score: 63.30
- Cost rank: 11
- Access rank: 14
- Outcomes rank: 3
With the third best illness prevention measures in the nation and as number one for elderly care, Minnesota is a good place to grow old in. The Land of a Thousand Lakes has low infant mortality and preventable death rates, but it is hindered by the fact that it costs more than the national average.
5. Maryland
- Healthcare score: 62.18
- Cost rank: 1
- Access rank: 10
- Outcomes rank: 18
With its All-Payer Model, Maryland’s health care is among the best states nationwide for treatment quality and equity. Treatment and costs are consistent throughout the state, providing high-quality care with only slightly above-average costs.
6. Vermont
- Healthcare score: 62.01
- Cost rank: 21
- Access rank: 5
- Outcomes rank: 6
The Green Mountain State’s expanding coverage and shrinking prices have slowly lowered the uninsured population yearly until reaching 97% in 2021. This quality coverage gives Vermont one of the lowest preventable death rates, but per capita prices still sit slightly above the national average.
7. Colorado
- Healthcare score: 61.35
- Cost rank: 27
- Access rank: 8
- Outcomes rank: 4
Though Colorado’s uninsured rate is about the same as the national average, the Centennial State has begun pushing the envelope for healthcare standards in ways that should increase access to and quality of care. The state has a below-average infant mortality rate and is rated as one of the best states to work in medicine.
8. Connecticut
- Healthcare score: 60.63
- Cost rank: 37
- Access rank: 6
- Outcomes rank: 5
In recent years, Connecticut has taken great strides to become one of the healthiest states in the union. With the signing of Executive Order 5 in 2020, the Constitution State took an important step toward lowering the cost of quality healthcare in their systems.
9. Maine
- Healthcare score: 59.60
- Cost rank: 34
- Access rank: 2
- Outcomes rank: 14
While Maine has historically been recognized for its great hospitals, they have also sat above average in per capita costs and rates of infant mortality and preventable death. In 2020, Maine expanded healthcare coverage and cut the costs of various treatments and medications. Such actions may push Maine higher on this list in the coming years.
10. Iowa
- Healthcare score: 58.80
- Cost rank: 6
- Access rank: 31
- Outcomes rank: 13
The Hawkeye State performs notably better than the US average in nearly every category. Infant mortality, preventable death, and healthcare prices paint a picture of fulfillment and efficiency. Without flair or complexity, Iowa beats most of the competition with consistent quality and low prices.
Worst States for Healthcare
1. Mississippi
- Healthcare score: 40.86
- Cost rank: 29
- Access rank: 40
- Outcomes rank: 51
While slightly cheaper than the national average, Mississippi healthcare yields the highest infant mortality rate in the US and a very poor preventable death rate. It is also rated the overall least healthy state in the nation.
2. Alabama
- Healthcare score: 41.27
- Cost rank: 36
- Access rank: 51
- Outcomes rank: 44
Alabama healthcare may be sitting on the precipice of collapse. Lower costs of care have not helped the quality. Alabama ranks among the least healthy states and holds worse positions than the averages for infant mortality, preventable deaths, and uninsured population.
3. Louisiana
- Healthcare score: 42.81
- Cost rank: 48
- Access rank: 25
- Outcomes rank: 49
The forty-ninth state in overall health, health care in the Pelican State costs slightly above the average and possesses frighteningly high infant mortality and preventable death rates.
4. Oklahoma
- Healthcare score: 43.25
- Cost rank: 43
- Access rank: 38
- Outcomes rank: 45
Nearly one in seven Oklahomans are uninsured, and this care often fails to provide consistent and quality care to those who need it. Though prices there are lower than the national average, it can’t be worth it when the care yields poor preventable death and infant mortality rates.
5. Arkansas
- Healthcare score: 44.30
- Cost rank: 5
- Access rank: 44
- Outcomes rank: 50
While slightly better on average in preventable death rates and health care, Arkansas fails in nearly every other category (infant mortality, overall health, etc.). Furthermore, the Natural State is rated as the worst state for health outcomes.
6. West Virginia
- Healthcare score: 44.94
- Cost rank: 30
- Access rank: 29
- Outcomes rank: 47
West Virginia is the least healthy state in the union in countless ways and has more preventable deaths per capita than any other. To combat this abundant ailment, the Mountain State has also implemented some of the highest costs in the nation.
7. South Carolina
- Healthcare score: 45.11
- Cost rank: 38
- Access rank: 49
- Outcomes rank: 41
While the Palmetto State is only a little worse than average in preventable death, infant mortality, and overall health, it is held back by poor accessibility, ranked 49th in the nation.
8. Texas
- Healthcare score: 45.86
- Cost rank: 46
- Access rank: 46
- Outcomes rank: 33
The Lone Star State has the single best preventable death rate and below-average costs. Nevertheless, this is betrayed by the fact that Texas also holds the highest uninsured rate and is consistently inaccessible.
9. Georgia
- Healthcare score: 46.21
- Cost rank: 28
- Access rank: 41
- Outcomes rank: 43
Beyond ranking poorly in infant and preventable mortality, Georgia’s health care has also been criticized for the abundant inequity plaguing its large minority populations. Health care in the Peach State has become inaccessible to many children, families, and individuals.
10. Tennessee
- Healthcare score: 46.21
- Cost rank: 23
- Access rank: 26
- Outcomes rank: 46
Most Tennessee healthcare statistics, such as infant mortality and overall health, are simply-sub standard. Another factor that damages the Volunteer State’s ranking is its lack of funding, which has led to many hospitals closing their doors and damaging accessibility statewide.
Healthcare Spending Statistics
In 2021, the National Health Expenditures (NHE) in the United States grew by 2.7% to reach a total of $4.3 trillion, or $12,914 per person. This accounted for 18.3% of the country’s Gross Domestic Product (GDP). Among the different sectors of healthcare spending, Medicare spending saw the most significant increase, growing by 8.4% to reach $900.8 billion, or 21% of total NHE.
Medicaid spending grew by 9.2% to reach $734.0 billion, or 17% of total NHE. Private health insurance spending increased by 5.8% to reach $1,211.4 billion, or 28% of total NHE. On the other hand, out-of-pocket spending saw the fastest growth at 10.4%, reaching $433.2 billion, or 10% of total NHE. In contrast, spending on Other Third Party Payers and Programs and Public Health Activity decreased by 20.7% in 2021 to $596.6 billion, or 14% of total NHE.
Hospital expenditures grew by 4.4% in 2021, reaching $1,323.9 billion, which is slower than the 6.2% growth seen in 2020. Similarly, physician and clinical services expenditures grew by 5.6% to reach $864.6 billion in 2021, which is slower than the 6.6% growth seen in 2020. Prescription drug spending, however, increased by 7.8% to reach $378.0 billion in 2021, which is faster than the 3.7% growth seen in 2020.
The federal government sponsored the largest share of total health spending, accounting for 34% of total health care spending. Households accounted for 27% of total health spending, private business for 17%, state and local governments for 15%, and other private revenues for 7%.
This data shows that while overall healthcare spending grew in 2021, there were variations among different sectors and funding sources.
