A Forbes Advisor study of the 50 states and the District of Columbia utilized 11 metrics from the Kaiser Family Foundation data to determine the states with the highest and lowest healthcare costs.
Healthcare costs continue to rise for Americans; in 2020, the average cost of healthcare per person averaged $10,000.
- Almost half (44%) of Americans surveyed found a medical bill below $1,000 unaffordable.
- The Forbes Advisor study found that the five most expensive states for healthcare were on the East Coast — Delaware, Florida, Maine, New Hampshire, and West Virginia.
- The least expensive states were Hawaii, Nevada, New Mexico, Oregon, and Washington on the West Coast.
- Michigan is the least expensive state for healthcare, while South Dakota is the most costly.
The 5 Most Expensive States for Healthcare
- South Dakota
- The annual average cost per capita is $11,736.
- South Dakota experienced the third-highest rise in healthcare costs over five years — up 24.38%.
- Their insurance premiums are the 6th highest in the nation — Affordable Care Act individual plans are $7,156 annually. The state also averages the 3rd most expensive deductible — $2,428 for a single individual with employer-provided insurance.
- 12% of children live in families where their parents struggled to pay their medical bills in 2019/2020.
- Employer-provided health insurance premiums are among the highest in the United States. Employees with a “plus one” plan pay the highest premium in the nation — $4,685 annually. Family plans are the second highest in the U.S. at $6,999.67 yearly.
- Louisiana’s increase in healthcare costs was 5th highest in the nation at 23.10%.
- West Virginia
- Individuals with health insurance through the Affordable Care Act marketplace pay $8,024 annually — the 4th highest premium in the nation.
- West Virginians experienced an increase in healthcare costs of 21.75% — the 8th highest rate in the U.S.
- Annual healthcare expenditures averaged $12,019 per capita — 7th highest in the nation.
- Employer-provided family health insurance in Florida is the highest in the nation — at $7,079.33 annually. The “one plus” employer-provided plan is the second highest in the country at $4,684.67 per year.
- Of the 1,056,000 Florida residents with unmet needs for mental health services, 51.9% could not receive care because of costs.
- Individual health insurance plan from the Affordable Care Act marketplace was the highest in the nation at $9,620 annually, over $1,400 more than Alaska, the second-highest individual rate in the United States.
- 7% of Wyoming residents with unmet mental health needs did not receive care because of associated costs.
The 5 Least Expensive States for Healthcare
- Employer-provided family plans at $4,199.67 annually and “one plus” plans at $3,261.33 yearly are the lowest costs in the nation.
- The 5-year increase in healthcare costs came in at 13.67%, the 6th lowest in the U.S.
- Residents pay $1,139.67 for single employer-provided insurance (3rd lowest), $3,388.67 for “one plus” (2nd lowest), and $5,121.67 for a family plan (2nd lowest).
- The 5-year healthcare cost increase was 14.43%, almost half of what the two highest states experienced.
- Annual expenditures for individuals come in at $8,118 per year, the 4th lowest in the U.S.
- The state also experienced the 3rd lowest 5-year cost increase — 13.16%.
- Hawaii is home to the only single-coverage employer-provided health insurance under $1,000 annually — averaging $846.67 annually.
- Hawaiians also have the lowest deductibles for insurance through their employer — $1,280.67 for an individual and $2,812.33 for family plans.
- New Mexico
- New Mexico is home to the 9th lowest annual health expenses — $8,505.
- Their residents have the 4th lowest rate for unmet mental health needs — coming in at 25.9%.
Consequences of Higher Healthcare Costs
Paying off medical debt impacts Americans — a Forbes Advisor study of 2,000 people revealed that 23% were paying off medical debt. Some of the ways include:
- Purchasing cheaper items
- Delaying travel plans and/or vacations
- Put off home improvement plans
- Defer saving for retirement
Americans have also been forced to delay healthcare. Here are how patients cope:
- 27% – put off doctor’s appointments
- 19% – delay a medical procedure
- 19% – not refilling a medical prescription
- 18% – postponing a physical examination
- 15% – going without mental health treatment
Most Americans cannot afford medical bills, even in the $500 to $1,000 range. They use a variety of methods, including accumulating credit card debt.
- 40% pay with a credit card
- 30% have it on a debit card
- 26% have an installment plan with their facility or other providers
- 16% use emergency savings
- 12% borrow from family or friends
Soaring healthcare costs influence career decisions — employees feel forced to stay at jobs they don’t like because of their company’s healthcare insurance plan. Others work full-time to qualify for health insurance when they prefer to work part-time.
High inflation rates are impacting Americans’ choices during open enrollment.
- Almost one-quarter of Americans (23%) say they will choose a plan with a lower premium.
- 11% indicate that they will select a plan with a lower deductible to cope with inflation.
- 7% anticipate using their health saving account to help deal with inflation.
The Forbes study reveals a dichotomy in several states — Hawaii and Washington are two of the top ten highest-income states but have some of the lowest healthcare costs. In contrast, West Virginia and Louisiana, two of the ten lowest-income states, have some of the highest healthcare costs.