Posted on 07/23/2025 10:01:01 PM PDT by SeekAndFind
Americans pay wildly different amounts for health insurance depending on where they live.
This map, via Visual Capitalist's Bruno Venditti, shows which states pay the most (and least) when health insurance costs are measured as a share of median income.
The data for this visualization comes from WalletHub. It analyzed silver-tier health plan premiums in all 50 states and compared them to local median incomes to determine cost burdens.
In Vermont, residents spend 19.6% of their monthly income on health insurance, the highest share in the country. West Virginia follows closely at 18.8%.
| Rank | State | Insurance as % of Income |
|---|---|---|
| 1 | Vermont | 19.6% |
| 2 | West Virginia | 18.8% |
| 3 | Alaska | 14.0% |
| 4 | Wyoming | 13.8% |
| 5 | New York | 10.9% |
| 6 | Mississippi | 10.5% |
| 7 | South Dakota | 10.2% |
| 8 | Louisiana | 10.2% |
| 9 | Alabama | 10.1% |
| 10 | New Mexico | 9.7% |
| 11 | Nebraska | 9.5% |
| 12 | Oklahoma | 9.3% |
| 13 | Montana | 9.3% |
| 14 | Arkansas | 9.2% |
| 15 | Tennessee | 9.2% |
| 16 | Maine | 9.1% |
| 17 | North Carolina | 8.6% |
| 18 | Florida | 8.6% |
| 19 | Connecticut | 8.5% |
| 20 | Missouri | 8.4% |
| 21 | South Carolina | 8.4% |
| 22 | Kansas | 8.4% |
| 23 | Kentucky | 8.4% |
| 24 | North Dakota | 8.3% |
| 25 | Georgia | 7.9% |
| 26 | Wisconsin | 7.7% |
| 27 | Delaware | 7.7% |
| 28 | Texas | 7.6% |
| 29 | Ohio | 7.5% |
| 30 | Oregon | 7.4% |
| 31 | Iowa | 7.0% |
| 32 | Utah | 7.0% |
| 33 | Pennsylvania | 7.0% |
| 34 | Idaho | 6.9% |
| 35 | Illinois | 6.9% |
| 36 | Michigan | 6.7% |
| 37 | Nevada | 6.6% |
| 38 | Indiana | 6.5% |
| 39 | Arizona | 6.0% |
| 40 | Hawaii | 5.9% |
| 41 | Colorado | 5.9% |
| 42 | California | 5.8% |
| 43 | New Jersey | 5.7% |
| 44 | Rhode Island | 5.6% |
| 45 | Washington | 5.3% |
| 46 | Massachusetts | 5.0% |
| 47 | Minnesota | 4.9% |
| 48 | Virginia | 4.9% |
| 49 | Maryland | 4.3% |
| 50 | New Hampshire | 4.0% |
Many Southern and Mountain West states, like Mississippi, Wyoming, and Louisiana, also rank high in insurance cost burden. These regions tend to have poorer health outcomes and lower median incomes, exacerbating affordability issues. As Brookings notes, Medicaid expansion status and rural demographics heavily influence insurance markets in these areas.
New Hampshire residents spend just 4% of their income on health insurance, the lowest in the nation.
Massachusetts, Maryland, and Minnesota also enjoy low cost burdens. These states often have robust state-run exchanges, higher incomes, and broader Medicaid expansion, all of which help reduce costs.
If you enjoyed today’s post, check out Ranked: U.S. Cities With the Most and Least Health Insurance on Voronoi, the new app from Visual Capitalist.
Medicare and Medicaid account for 26% of federal spending, and only pays out to 37% of the population. By extension, to cover 100% of the population would consume 70% of our current budget.
Health care insurance is the largest industry in the USA (by revenue).
Healthcare & Medical Practices are the 2nd largest industry in the USA.
Pharmaceutical is the 4th largest industry in the USA.
Healthcare is bankrupting America.
That is a very poor graph. Should have the colors reversed since people associate “being in the red” as unaffordable.
Must have been created by foreign born H1-B types.
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“Healthcare is bankrupting America.”
It’s up to RFK - he’s nibbling at the edges now, but has to ‘go there’ if he wants end the ever escalating sickness and resulting healthcare cost in America, but so far he’s keeping clear of the ‘elephant in the living room’, which, of course, is the fact that carbs are now poisoning Americans (along with literally every other country), so nothing has changed much...yet.
Ratios and percentages can be very misleading. Usually, people are encouraged to focus on the numerator. Many people forget the denominator. A high number can indicate that medical costs are high, or that income is low. Each could happen for many different reasons.
I’ve had no health insurance since I retired. I use the VA or the local rural clinic in emergencies. By my calculations, I’ve spent about $1,200 out of pocket... and saved $51,000.
My wife and I are in Illinois, we’re retired, and our out of pocket insurance premiums have RISEN by about $80. Not including Medicare’s rate increase. We both have SS, she has a small pension. We are getting squeezed. So also are our renters and auto insurance. Our driving record is good- when we asked the insurance agent ( State Farm) why the increase, all he said was “inflation”. BS.
Thanks for the information. This is what we get for choosing government intervention in health care.
Am I right that emergency rooms cannot, by law (edict, regulation, etc.), turn people away? I think that has been the case for decades.
An alternative would have been to encourage people to pay on time, if they could not pay out-of-pocket. A low-income 20-year-old who needs ER service could pay over the next four years, or longer.
The basic principle is that you should receive the service that you pay to receive. If they baby-boom generation can and chooses to pay for medical care in their later years, that’s ok with me. If not, that’s ok too. People need an incentive to work and save. Medical care in one’s “golden years” is one reason to work and save.
Oh, and our rent went up, too, but that’s another story….
Interesting that Vermont is the highest, with its next-door neighbor, New Hampshire being the lowest.
Review
Correct. I doubt health insurance cost varies much between states. I see this as more of a household income map, skewed by those who get free healthcare.
EC
Divide and conquer of the state insurance boards. Legalized criminal enterprise. BTW, turns out the medicare limitation on once in a lifetime carrier selection without underwriting is state controlled. Oklahoma is somewhat changing that this year with non-underwriting change allowed on your birthday.
What a racket.
Shocking but not surprising statistics. Where did you come by them?
For all this cost and yet rural health care is substandard even by world standards. Our little hospital in the adjacent county just went bankrupt and closed along with the little clinic. Just as well the clinic closed since the admin could not keep help and made using it a horrible experience.
It seems like this should be unsustainable doesn’t it? It is also unconscionable that just about all of those getting revenue claim they don’t make enough money and don’t pay their help enough to keep them. The competition for the little clinic that I mention above to keep half-way admin staff is pot farms. Tending pot in a greenhouse pays better than working in healthcare. Somebody else is getting a hell of a big cut of the pie.
When I worked in Brazil I would go to the farmacia and be amazed at how cheap and OTC medications were that I bought here only with prescription and at sometimes 10 times the cost. The one I stocked up on was Valtoran for pain and a 2% antifungal. Both were dirt cheap compared to here and both required a prescription.
I also saw a Lebanese doctor in Nigeria for dysentery paying him cash. He was very competent, trained in France, and very reasonable.
The US has great technology but the most expensive health care system in the world and it is inexcusable. It exists because of what we consider “normal” and our ability to pay. The cost is also horrible because it includes so many who pay nothing. The ability for the nation to pay is unsustainable. The price of access is criminal.
I researched it myself a few months and found multiple sources.
Here’s one:
https://www.globalsources.com/knowledge/top-10-largest-industries-by-revenue-in-the-us-in-2025/
We are definitely not getting what we are paying for. There is to much bureaucracy between the consumer and caregiver, completely insulating healthcare from market forces.
The phenomenal rise in the number of administrative positions, highly paid or not, has done little or nothing to improve health care and everything to raise the price of it. Thank Nixon and his buddy George Kaiser in the 70s and then the obama docudrama of “affordable health care”.
The questions are, can it ever be fixed and how? Will we ever see something like world class reasonable cost and quality of health care in the US? Not likely in my remaining lifetime if at all.
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