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With the cost of living rising across the globe, many people are being left unable to pay for basic everyday necessities, such as food, utility bills and healthcare.
The cost of international health insurance and prescription medication is rapidly increasing and American citizens are being forced to prioritize their necessities, meaning that many of them are left unable to afford life-saving medications or hospital treatment. It is estimated that 6.3% of adults aged 18 or over in the US have failed to obtain medical care, due to the cost.
There are thought to be approximately 29.6 million (11%) US citizens who are currently uninsured when it comes to healthcare. This includes 4.1% of children under the age of 18 and 13.5% of adults aged between 18-64.
The Price of US Health: Which US states are spending the most on healthcare?
We explore which of the US states is spending the most on their healthcare and which illnesses will cost you the most to get treated.
The most expensive states for healthcare
1/ Massachusetts
9.58/10 overall score
It looks as though the residents of Massachusetts are paying the most when it comes to their health, as the state has an overall score of 9.58.
On average, the state has expenses of US$3,462 per patient day. Residents pay a huge US$10,559 for their healthcare and US$268.21 for their prescription.
2/ Connecticut
8.82/10 overall score
Coming in second is Connecticut, with an overall score of 8.82.
Residents pay around US$9,859 for their healthcare and US$207.44 for their prescription. The state also has expenses of US$3,290 per patient day.
3/ New York
8.47/10 overall score
In third place is New York, with an overall score of 8.47.
New York has expenses of US$3,676 per patient day. Residents pay around US$9,778 for their healthcare and US$157.69 for their prescription.
The least expensive states for healthcare
1/ Georgia
1.46/10 overall score
The least expensive state in regards to health is Georgia, scoring 1.46 overall.
Georgia has expenses of US$2,100 per patient day. Residents pay around US$6,587 for their healthcare and just US$99.43 for their prescription.
2/ Kansas
2.22/10 overall score
Coming in second is Kansas, with an overall score of 2.22.
Residents pay around US$7,651 for their healthcare and just US$79.38 for their prescription. The state has an average of US$2,191 in expenses per patient day.
3/ Arizona
2.50/10 overall score
In third place is Arizona, with an overall score of 2.50.
Arizona has expenses of US$3,131 per patient day. Residents pay US$6,452 for their healthcare and just US$64.51 for their prescription.
Which states have the highest overall healthcare costs?
1/ Alaska
US$11,064 per person
At the top of the list is Alaska, with overall healthcare costs of US$11,064 per person.
Despite being the largest US state by area, Alaska is the third least populous state. Due to the relatively small population, there are only a limited number of medical service providers available, with specialty physicians charging particularly high fees. Because of this, the citizens of Alaska are forced to pay these high healthcare costs.
2/ Massachusetts
US$10,559 per person
In second place is Massachusetts, with overall healthcare costs of US$10,559 per person.
Massachusetts regularly ranks highly amongst the other states when it comes to healthcare. In 2006, the state passed a healthcare reform law, which mandated that nearly every citizen of Massachusetts should receive a minimum level of insurance coverage. Despite 98% of residents having health coverage after the reform, it did not decrease the total costs of healthcare.
3/ Delaware
US$10,254 per person
Coming in third is Delaware, with overall healthcare costs of US$10,254 per person.
Despite being the second smallest and the sixth least populous state, Delaware has a very large employment rate within the healthcare sector. However, the state has rather high healthcare costs which are driven by a range of factors, such as having the country’s 5th oldest population, the 7th highest adult obesity rate and the 11th highest rate of adult diabetes.
Which states have the lowest overall healthcare costs?
1/ Utah
US$5,982 per person
At the top of the list is Utah, with overall healthcare costs of US$5,982 per person.
Utah has the youngest population of any US state and despite this, has the lowest child-poverty rate in the country. The state also ranks amongst the highest in total fertility rate. These factors are just some of the reasons why Utah’s healthcare costs are so low compared to other states.
2/ Arizona
US$6,452 per person
In second place is Arizona, with overall healthcare costs of US$6,452 per person.
In 2020, Arizona passed the Senate Bill 1523 and House Bill 2764, which are collectively known as Jake’s Law. The legislation was named after Jake Denslow, a 15 year old boy who unfortunately passed away by suicide, after facing an insurance denial for a longer in-patient mental health stay. Jake’s Law requires Arizona health care insurers to cover mental health without additional barriers.
3/ Georgia
US$6,587 per person
Coming in third is Georgia, with overall healthcare costs of US$6,587 per person.
Georgia’s rates for suicide and alcohol and drug-related deaths are below the nation’s averages. The state’s teenage pregnancy rate is also less than half of what it was two decades ago. The community health centers and hospitals in Georgia also provide vast access to primary, preventive and acute care services for low-income and underserved residents.
The states with the highest expenses per patient day
Patient day refers to all days during which a resident, regardless of payment source, occupies a bed. Adjusted expenses per patient day include expenses incurred for both in-patient and out-patient care; in-patient days are adjusted higher to reflect an estimate of the volume of out-patient services.
1/ California
US$4,098 per patient day
Topping the list is California, with expenses of US$4,098 per patient day.
The state – which has the highest population, approximately 39,995,077 people – has the second highest number of hospitals. California public health systems serve over 3.7 million people per year and operate over half of the state’s top-level trauma and burn centers.
2/ Oregon
US$3,986 per patient day
In second place is Oregon, with expenses of US$3,986 per patient day.
The state’s largest hospital, Oregon Health and Science University Hospital, is nationally ranked in a range of adult specialties: cancer care, ENT (ear, nose and throat), geriatrics, neurology and neurosurgery, and pulmonology and lung surgery. The hospital attended to over 27,000 people who required emergency care in 2021.
3/ Washington
US$3,945 per patient day
Third, is Washington, with expenses of US$3,945 per patient day.
Although there are many hospitals across the state, the majority of Washington’s top-level medical centers are located in and around Seattle. The state’s largest hospital, Swedish Medical Centre – First Hill Campus, has received a high-performing rating in the following adult procedures and conditions: kidney and heart failure, lung and colon cancer surgery, knee and hip replacement, pneumonia and COPD (chronic obstructive pulmonary disease).
The states with the lowest expenses per patient day
1/ Mississippi
US$1,311 per patient day
Topping the list is Mississippi, with expenses of just US$1,311 per patient day.
The state’s largest hospital, North Mississippi Medical Center, serves over 730,000 people and is designated as a Level II trauma center by the Mississippi State Department of Health. The hospital’s program has also been recognized by The American Journal of Medicine for providing cost-efficient care to hospitalized patients.
2/ Wyoming
US$1,466 per patient day
In second place is Wyoming, with expenses of US$1,466 per patient day.
The state’s largest hospital, Banner Wyoming Medical Center, spans two campuses and features 14 primary, specialty and immediate care clinics. The center partnered with Banner Health in October 2020, in order to become the healthcare system’s flagship hospital for the state of Wyoming.
3/ South Dakota
US$1,642 per patient day
Coming in third is South Dakota, with expenses of US$1,642 per patient day.
The state’s largest hospital, Sanford USD Medical Center, provides comprehensive care including emergency air transport, neonatal and pediatric intensive care and transplant services.
Which states have the highest average prescription costs?
1/ Rhode Island
US$288.37 average prescription cost
At the top of the list is Rhode Island, with an average prescription cost of US$288.37.
The state recently announced that they are planning to provide extra help towards paying for prescription drugs, for those on low income beneficiaries. They will also be capping the price of insulin at no more than US$35 for a month’s supply, due to the rapidly increasing prices that have been introduced by drug manufacturers.
2/ Massachusetts
US$268.21 average prescription cost
In second place is Massachusetts, with an average prescription cost of US$268.21.
The state recently announced plans to penalize drug manufacturers who increase the price of medication above its reference price. Any manufacturers who exceed the threshold would be required to pay a penalty of 80% of the amount above the excessive price threshold, meaning that they would essentially only be collecting 20% of the revenue above the price cap.
3/ North Dakota
US$222.36 average prescription cost
Third, is North Dakota, with an average prescription cost of US$222.36.
Starting in 2024, the state will be capping Medicare beneficiary out-of-pocket costs at US$2,000. For the first time ever, all 97,000 Medicare Part D beneficiaries in North Dakota will have their pharmacy costs capped, due to improved financial protections. This will benefit approximately 5,200 citizens per year, whose out-of-pocket costs would otherwise be above the cap.
Which states have the lowest average prescription costs?
1/ Maine
US$22.39 average prescription cost
At the top of the list is Maine, with an average prescription cost of just US$22.39.
This follows a period between the years of 1991-2014, where prescription costs in Maine nearly tripled. In 1991, residents of Maine were spending an average of US$403 per person per year on prescriptions. By 2014, this had increased to US$1,159!
2/ Arizona
US$64.51 average prescription cost
In second place is Arizona, with an average prescription cost of US$64.51.
This follows the huge price increase of prescription drugs during Donald Trump’s time as President. This led to 26% of Arizona residents reporting that they had stopped taking prescription medication as instructed, due to the inflated cost.
3/ Indiana
US$68.57 average prescription cost
Coming in third is Indiana, with an average prescription cost of US$68.57.
Drug manufacturers rebate around US$1 billion back to Indiana and the federal government, which is 53% of the total Medicaid spending on drugs in the state. Only 5.9% of the Medicaid budget in Indiana is spent on retail brand and generic prescription drugs.
The states with the best availability of resources
Resources refers to the number of non-federal, short-term, acute care hospitals and staffed beds for community hospitals within each state.
States with the best availability of resources: Hospitals
1/ South Dakota
2.66 hospitals per 100,000 people
At the top of the list is South Dakota, with 2.66 hospitals per 100,000 people.
The state has a total of 24 hospitals serving a population of approximately 901,165 people. South Dakota’s largest hospital, Sanford USD Medical Centre, is regularly featured in the Top 100 Hospitals throughout the nation and is the only verified Pediatric Trauma Center in the state.
2/ Wyoming
2.42 hospitals per 100,000 people
In second place is Wyoming, with 2.42 hospitals per 100,000 people.
The state has a total of 14 hospitals serving a population of approximately 579,495 people. Wyoming’s largest hospital, Banner Wyoming Medical Center, is a regional trauma and referral center, and provides comprehensive care to heart, stroke and trauma patients.
3/ Mississippi
2.36 hospitals per 100,000 people
Third, is Mississippi, with 2.36 hospitals per 100,000 people.
The state has a total of 70 hospitals serving a population of approximately 2,960,075 people. Mississippi’s largest hospital, North Mississippi Medical Center, has staff members representing over 50 medical specialties and centers of excellence in areas such as cardiology, cancer treatment and neonatal programs.
States with the best availability of resources: Hospital beds
1/ South Dakota
475 hospital beds per 100,000 people
At the top of the list again is South Dakota, with 475 hospital beds available per 100,000 people.
The state has a total of 4,279 hospital beds, with 545 of them being situated at South Dakota’s largest hospital, Sanford USD Medical Center.
2/ North Dakota
420 hospital beds per 100,000 people
In second place is North Dakota with 420 hospital beds available per 100,000 people.
The state has a total of 3,360 hospital beds, with 284 of them being situated at North Dakota’s largest hospital, Sanford Medical Center Fargo. The hospital has 27 operating rooms, which feature the most advanced technology in the nation.
3/ Mississippi
399 hospital beds per 100,000 people
Third, again, is Mississippi, with 399 hospital beds available per 100,000 people.
The state has a total of 11,796 hospital beds, with 640 of them being situated at Mississippi’s largest hospital, North Mississippi Medical Center.
The states with the worst availability of resources
Resources refers to the number of non-federal, short-term, acute care hospitals and staffed beds for community hospitals within each state.
States with the worst availability of resources: Hospitals
1/ Washington
0.76 hospitals per 100,000 people
At the top of the list is Washington, with 0.76 hospitals per 100,000 people.
The state has a total of 60 hospitals serving a population of approximately 8 million people. Washington’s largest hospital, Swedish Medical Center First Hill, is the largest and most comprehensive community hospital in the Pacific Northwest. It is known as a regional referral center, which specializes in areas such as cardiovascular care, cancer care and organ transplantation.
2/ Delaware
0.79 hospitals per 100,000 people
In second place is Delaware, with 0.79 hospitals per 100,000 people.
The state has a total of 8 hospitals serving a population of approximately 1 million people. Delaware’s largest hospital, Christiana Hospital, includes the state’s only Level I trauma center and is prepared to handle the most extreme medical emergencies.
3/ New Jersey
0.83 hospitals per 100,000 people
Coming in third is New Jersey, with 0.83 hospitals per 100,000 people.
The state has a total of 78 hospitals serving a population of approximately 9,388,414 people. New Jersey’s largest hospital, Hackensack University Medical Center, has more nationally ranked specialties than any other hospital in New Jersey, including their Urology and Neurology & Neurosurgery programs.
Maryland and Oregon both also have 0.83 hospitals per 100,000 people. Maryland has a total of 52 hospitals serving a population of 6,257,958 people and Oregon has a total of 36 hospitals serving a population of 4,318,492 people.
States with the worst availability of resources: Hospital beds
1/ Washington
154 hospital beds per 100,000 people
At the top of the list, again, is Washington, with 154 hospital beds per 100,000 people.
The state has a total of 12,205 hospital beds, with 649 of them being located at Washington’s largest hospital, Swedish Medical Center First Hill.
2/ Oregon
161 hospital beds per 100,000 people
In second place is Oregon, with 161 hospital beds per 100,000 people.
The state has a total of 6,971 hospital beds, with 576 of them being located at Oregon’s largest hospital, Oregon Health and Science University Hospital.
3/ Utah
175 hospital beds per 100,000 people
Coming in third is Utah, with 175 hospital beds per 100,000 people.
The state has a total of 5,891 hospital beds, with 613 of them being located at Utah’s largest hospital, The University of Utah Hospital.
What are the most expensive medical procedures?
1/ Exploratory chest surgery
Average cost – US$137,533
At the top of the list is exploratory chest surgery, costing an average of US$137,533.
This type of procedure is commonly carried out as emergency surgery after an accident or injury. It allows surgeons to check for any potential issues or risks involving the heart and lungs.
2/ Aortic valve replacement
Average cost – US$135,984
In second place is aortic valve replacement, costing an average of US$135,984.
This procedure is a type of open heart surgery and is carried out in order to treat problems with the heart’s aortic valve, which controls the flow of blood from the heart to the rest of the body. It is used to treat two main diseases: aortic stenosis (where the valve is narrowed and therefore restricting blood flow) and aortic regurgitation (where the valve allows blood to leak back into the heart).
3/ Partial removal of the esophagus
Average cost – US$113,756
Third, is the partial removal of the esophagus, costing an average of US$113,756.
This type of procedure is carried out in order to remove some of the swallowing tube between your mouth and stomach, before reconstructing it using part of another organ, usually the stomach. It is commonly used as a treatment for esophageal cancer.
What are the most affordable medical procedures?
1/ Kidney transplant
Average cost – US$46,760
At the top of the list is kidney transplant, costing an average of US$46,760.
This type of procedure is carried out in order to transfer a healthy kidney from one person, to the body of someone who has little to no kidney function. The most common reason for needing a kidney transplant is due to kidney failure or end-stage chronic kidney disease.
2/ Aneurysms and artery disorders inside the skull
Average cost – US$46,763
In second place are aneurysms and artery disorders inside the skull, costing an average of US$46,763.
Brain aneurysms occur when there is a bulge or ballooning in a blood vessel within the brain. There are two common treatment options for brain aneurysms: surgical clipping, where a tiny metal clip is placed onto the neck of the aneurysm in order to stop blood flow to it, and endovascular treatment, where a catheter is inserted into an artery, before being threaded through the body and a device is used to destroy the aneurysm.
3/ Bowel-to-bowel fusion
Average cost – US$47,114
Third, is a bowel-to-bowel fusion, costing an average of US$47,114.
Bowel obstructions occur when there is a blockage within the small or large intestine, by something other than fecal matter, and can be caused by various forms of cancer, such as colon, bowel and ovary. Treatment options can vary depending on whether the obstruction is classed as acute or chronic.
Wherever you move, go with total peace of mind
At William Russell, we have 30 years’ experience of helping expatriates finding best places in the world to move abroad and settle into their new lives overseas by providing world-class international health insurance. Plus, we produce lots of expert material to help you and your family adapt to life abroad.
Making the move to another country can be challenging. But no matter where you go, you can take one thing off your mind. William Russell offers international health insurance that covers you for everything from minor injuries to long hospital stays, and we can even offer medical evacuations to patients who require treatment in other countries.
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Learn more about our plansMethodology
First, we collated a list of the 50 US states by using the U.S Embassy & Consulates website. We then gathered the population numbers for each state using World Population Review.
To gather the number of non-federal, short-term, acute care hospitals within each state, we used ahd.com. We then worked out how many hospitals are available per 100,000 people by dividing the number of hospitals by the population, before multiplying the total by 100,000.
To find out the number of hospital beds within each state, we used KFF. We then worked out how many hospital beds are available per 100,000 people by dividing the number of hospital beds by the population, before multiplying the total by 100,000.
We also used KFF to collect the total expenses per patient day for each state and World Population Review to find out each state’s overall healthcare costs. Patient day refers to all days during which a resident, regardless of payment source, occupies a bed. Adjusted expenses per patient day include expenses incurred for both in-patient and out-patient care; in-patient days are adjusted higher to reflect an estimate of the volume of out-patient services.
To calculate the average prescription cost per state, we used Definitive Healthcare. We took the total prescription charges and divided it by the number of prescriptions, in order to calculate the average prescription cost per person.
To find out which medical procedures cost the most in the US, we used an article by CBS News, which used data from healthcare data company, Arcadia.
To find out which states are the most expensive when it comes to health, we took all three of the money-related factors – total expenses per in-patient day, average prescription cost and overall healthcare costs – and gave each state a normalized score for each of the factors. We then took our final overall score as an average across all three factors. The state of Utah was not included within the overall ranking, as there was insufficient data for the average prescription cost within the state.
