Healthcare Cost by State: 2026 Report

Sep 17

4 min read

What you pay for health care depends heavily on where you live. In this report, we benchmark healthcare cost by state using two measures: per-capita personal health care spending, which captures the total cost of care per resident, and the average monthly marketplace insurance premium, which reflects what individuals pay to be covered. The heat map below shows how per-capita spending varies across the country.

Healthcare Cost by State: Heat Map

Per-capita personal health care spending ranges from $7,522 in Utah to $14,381 in the District of Columbia, a gap of nearly $6,900 per person¹. Spending is highest across the Northeast and parts of the Upper Midwest, and lowest across the Mountain West and Sun Belt, driven by differences in population age, service prices, chronic disease rates, and hospital market concentration.

Per Capita Health Care Spending by State, 2026

The table below ranks every state by per-capita personal health care spending, including all privately and publicly funded services such as hospital care, physician services, nursing home care, and prescription drugs. The national average is $10,191 per person¹.

Rank	State	Per Capita Health Care Spending	vs. National Average
1	District of Columbia	$14,381	+41%
2	New York	$14,007	+37%
3	Alaska	$13,642	+34%
4	Massachusetts	$13,319	+31%
5	Delaware	$12,899	+27%
6	West Virginia	$12,769	+25%
7	Vermont	$12,756	+25%
8	South Dakota	$12,495	+23%
9	Connecticut	$12,489	+23%
10	Maine	$12,077	+19%
11	New Jersey	$11,868	+16%
12	New Hampshire	$11,793	+16%
13	Rhode Island	$11,694	+15%
14	Pennsylvania	$11,603	+14%
15	North Dakota	$11,301	+11%
16	Wyoming	$10,989	+8%
17	Minnesota	$10,846	+6%
18	Maryland	$10,839	+6%
19	Indiana	$10,517	+3%
20	Louisiana	$10,515	+3%
21	Nebraska	$10,514	+3%
22	Ohio	$10,478	+3%
23	California	$10,299	+1%
24	Hawaii	$10,291	+1%
25	Kentucky	$10,257	+1%
26	Montana	$10,212	0%
27	Illinois	$10,190	0%
28	Oregon	$10,071	-1%
29	Wisconsin	$9,982	-2%
30	Missouri	$9,921	-3%
31	Michigan	$9,897	-3%
32	Florida	$9,856	-3%
33	Iowa	$9,789	-4%
34	Oklahoma	$9,444	-7%
35	Kansas	$9,408	-8%
36	Mississippi	$9,394	-8%
37	Arkansas	$9,338	-8%
38	Tennessee	$9,336	-8%
39	Alabama	$9,280	-9%
40	Washington	$9,265	-9%
41	Virginia	$9,195	-10%
42	North Carolina	$8,917	-13%
43	New Mexico	$8,902	-13%
44	South Carolina	$8,766	-14%
45	Georgia	$8,758	-14%
46	Arizona	$8,756	-14%
47	Colorado	$8,583	-16%
48	Texas	$8,406	-18%
49	Nevada	$8,348	-18%
50	Idaho	$8,148	-20%
51	Utah	$7,522	-26%
—	National Average	$10,191	—

New England and the Mideast post the highest regional spending, at roughly 23 to 25 percent above the national average, while the Rocky Mountain and Southwest regions sit well below it. A younger population is the single biggest reason Utah, Idaho, Nevada, and Arizona rank at the bottom, since older residents use more care.

Average Monthly Insurance Premium by State, 2026

Total spending is only part of the picture. The table below shows the average monthly marketplace insurance premium in each state for 2025 and 2026. The national average premium rose from $621 to $752 per month, a 21 percent increase, as enhanced Affordable Care Act subsidies expired².

Rank	State	2025 Monthly Premium	2026 Monthly Premium	Change
1	Vermont	$1,157	$1,224	+5.8%
2	New York	$1,134	$1,154	+1.8%
3	West Virginia	$929	$1,121	+20.7%
4	Wyoming	$1,007	$1,091	+8.3%
5	Alaska	$1,088	$1,037	-4.7%
6	New Mexico	$608	$917	+50.8%
7	Georgia	$658	$861	+30.9%
8	Florida	$647	$859	+32.8%
9	Arkansas	$494	$823	+66.6%
10	Texas	$586	$787	+34.3%
11	Tennessee	$556	$770	+38.5%
12	Wisconsin	$672	$765	+13.8%
13	Delaware	$578	$759	+31.3%
14	Mississippi	$541	$743	+37.3%
15	North Carolina	$601	$737	+22.6%
16	South Carolina	$601	$733	+22.0%
17	Kansas	$599	$727	+21.4%
18	Oklahoma	$587	$724	+23.3%
19	Indiana	$546	$722	+32.2%
20	Missouri	$572	$718	+25.5%
21	Louisiana	$583	$715	+22.6%
22	Iowa	$574	$703	+22.5%
23	Nebraska	$590	$702	+19.0%
24	Kentucky	$555	$700	+26.1%
25	Michigan	$526	$698	+32.7%
26	Nevada	$533	$696	+30.6%
27	Idaho	$580	$694	+19.7%
28	Arizona	$529	$692	+30.8%
29	Ohio	$563	$692	+22.9%
30	Alabama	$564	$691	+22.5%
31	Pennsylvania	$558	$685	+22.8%
32	Montana	$598	$683	+14.2%
33	Oregon	$544	$681	+25.2%
34	South Dakota	$640	$677	+5.8%
35	North Dakota	$559	$673	+20.4%
36	Virginia	$529	$670	+26.7%
37	Illinois	$520	$668	+28.5%
38	Colorado	$527	$666	+26.4%
39	Connecticut	$534	$666	+24.7%
40	New Jersey	$461	$589	+27.8%
41	California	$468	$587	+25.4%
42	Minnesota	$437	$557	+27.5%
43	Washington	$528	$557	+5.5%
44	Hawaii	$434	$556	+28.1%
45	Rhode Island	$434	$554	+27.6%
46	Massachusetts	$453	$545	+20.3%
47	Utah	$449	$537	+19.6%
48	New Hampshire	$368	$482	+31.0%
49	Maryland	$429	$480	+11.9%
50	District of Columbia	$387	$470	+21.4%
—	National Average	$621	$752	+21.1%

Premiums do not track total spending. Some low-spending states, such as Vermont and West Virginia, carry the highest premiums, while several high-spending states keep premiums lower through state-based marketplaces and reinsurance. The 2026 jump is driven mostly by the expiration of enhanced federal subsidies rather than by underlying cost growth alone.

What Drives Healthcare Cost Differences by State

Four factors explain most of the variation. Population age raises spending in states with more retirees. Hospital and specialist market concentration lets providers charge more where competition is limited. Chronic disease prevalence increases utilization in the South. And whether a state expanded Medicaid shapes how much uncompensated care shifts onto private premiums.