CostOfLivingByState

Healthcare Costs by State 2026

Average ACA marketplace premiums, annual healthcare spending, and uninsured rates for all 50 states. Plus the trade-off no one talks about: cheap healthcare states often have the worst access.

All 50 states

Healthcare costs ranked

StateAnnual spend (per person)Avg ACA premiumUninsuredHospitals/100kMedicaid
Mississippi$7,080$475/mo11.8%2.0Not expanded
Arkansas$7,120$450/mo8.4%2.2Expanded
New Mexico$7,190$398/mo10.5%2.0Expanded
Louisiana$7,210$498/mo8.4%2.1Expanded
Alabama$7,250$438/mo9.6%1.9Expanded
Oklahoma$7,260$455/mo13.2%2.4Expanded
Tennessee$7,290$445/mo9.8%1.8Not expanded
Kentucky$7,320$425/mo5.3%2.0Expanded
Utah$7,340$398/mo8.5%1.4Expanded
West Virginia$7,340$465/mo5.2%2.4Expanded
Arizona$7,480$395/mo9.1%1.4Expanded
Georgia$7,480$468/mo12.4%1.5Not expanded
Missouri$7,500$425/mo8.1%2.2Expanded
Texas$7,520$498/mo17.3%1.3Not expanded
Colorado$7,540$425/mo6.5%1.5Expanded
Florida$7,560$565/mo12.7%1.3Not expanded
Indiana$7,560$415/mo7.6%1.7Expanded
Idaho$7,580$410/mo8.2%2.0Expanded
South Carolina$7,630$468/mo9.5%1.6Not expanded
Kansas$7,710$405/mo7.8%2.8Not expanded
Montana$7,710$445/mo7.5%3.2Expanded
Virginia$7,710$455/mo7.2%1.4Expanded
Ohio$7,760$408/mo6.0%1.7Expanded
Iowa$7,810$395/mo4.8%2.5Expanded
North Carolina$7,810$488/mo9.8%1.5Expanded
Michigan$7,840$398/mo5.4%1.6Expanded
Nevada$7,890$445/mo10.2%1.1Expanded
Nebraska$7,940$410/mo6.5%3.0Expanded
Illinois$8,050$420/mo6.2%1.4Expanded
Minnesota$8,050$412/mo4.2%2.1Expanded
Washington$8,050$445/mo5.8%1.3Expanded
Wisconsin$8,070$418/mo4.8%1.9Not expanded
Oregon$8,080$445/mo5.8%1.5Expanded
Pennsylvania$8,120$445/mo5.5%1.8Expanded
Wyoming$8,180$478/mo9.8%4.5Not expanded
Maryland$8,420$488/mo6.0%1.3Expanded
North Dakota$8,420$435/mo6.8%4.2Expanded
South Dakota$8,440$448/mo8.2%3.8Not expanded
New Jersey$8,600$512/mo7.5%1.3Expanded
California$8,620$524/mo6.8%1.1Expanded
New York$8,680$575/mo5.2%1.5Expanded
Delaware$8,850$510/mo5.9%1.5Expanded
Hawaii$8,850$395/mo4.1%1.6Expanded
Rhode Island$9,050$478/mo3.8%1.6Expanded
New Hampshire$9,090$458/mo5.5%1.9Expanded
Connecticut$9,180$582/mo5.2%1.7Expanded
Massachusetts$9,280$548/mo2.9%1.8Expanded
Vermont$9,300$548/mo3.2%2.5Expanded
Maine$9,380$465/mo5.8%2.3Expanded
Alaska$11,890$720/mo11.2%2.8Expanded

This page carries no healthcare price index. The federal price-parity series used elsewhere on this site, BEA Regional Price Parities by State, does not publish a healthcare parity: medical goods fall inside its goods parity and medical services inside its other-services parity, and BEA does not break either out. The table is ordered by annual spending per person, which measures outlay rather than price. Sources: KFF Health System Tracker 2026, Healthcare.gov marketplace data, US Census ACS, AHA hospital data.

The hidden trade-off

Cheap healthcare doesn't mean good healthcare.

Mississippi has the lowest healthcare spending but the worst rural hospital access in the country - 13 rural hospitals have closed since 2010. Oklahoma and Texas also spend relatively little yet carry among the highest uninsured rates. The Commonwealth Fund's annual scorecards consistently put cheap-healthcare states in the bottom 10 for outcomes.

For young, healthy adults this matters less. For retirees, families with chronic conditions, or anyone planning to start a family, healthcare quality should weight alongside cost. Massachusetts is expensive but world-class; Vermont and Hawaii score well on access despite higher costs.

See the retirement composite ranking →

Frequently Asked

Healthcare costs, answered

Which state has the cheapest healthcare?
There is no federal answer to that question. BEA, which publishes the price parities used everywhere else on this site, does not break healthcare out: medical goods sit inside its goods parity and medical services inside its other-services parity. On reported spending rather than prices, Mississippi is lowest at around $7,080 per person per year. The catch: cheapest doesn't mean best access. The Commonwealth Fund's healthcare scorecards consistently rank the cheapest states in the bottom half for access and quality.
What state has the highest healthcare costs?
On annual spending per person, Alaska at around $11,890, driven by high insurance premiums, expensive specialist care, and limited rural delivery infrastructure. Massachusetts and Maine also rank high; both have universal-ish coverage but high underlying medical pricing.
How much does an ACA marketplace plan cost?
The unsubsidised average for a silver plan, single adult age 40, ranges from $395/month (lowest, Hawaii and Arizona) to $720/month (highest, Alaska). Subsidies under the ACA can reduce premiums substantially based on household income. The Healthcare.gov plan finder tool shows your actual subsidised cost.
Which states haven't expanded Medicaid?
Of 50 states, 40 have expanded Medicaid under the ACA. The non-expansion states (Alabama, Florida, Georgia, Mississippi, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, Wyoming) leave a coverage gap for adults earning between 100% of the federal poverty level and the threshold for marketplace subsidies. This contributes to higher uninsured rates: Texas (17.3%), Oklahoma (13.2%), Florida (12.7%) lead the country.
Should retirees prioritise healthcare quality over cost?
Almost always. Healthcare needs increase substantially with age, and a 'cheap' state with limited rural hospital coverage can mean long drives, poor specialist access, or worse outcomes for chronic conditions. Massachusetts and Vermont consistently top healthcare quality rankings; their costs are higher but for retirees with assets, the trade-off often favours quality. See our retirement page for the composite ranking.

Reader questions

Something this site doesn't answer?

Write to us. A person reads every message and we answer the ones we can, with the source cited. If your question would help other readers, we may publish an anonymised version, and we ask you first. Price-level figures here are a general reference for comparing states, not financial or relocation advice, so check your own move with a certified financial planner.

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