15 Worst States for Health Care in the US

Last Updated: 7/7/2022
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Where you live may determine what kind of health care you can get — and how much you have to spend to get it. The cost of health insurance varies widely across states. People have more trouble getting health insurance coverage and finding affordable health care options in some places than in others.

To quantify these differences across the U.S. and identify the best and worst states for health care, MoneyGeek analyzed and compiled a wide range of data. We looked at factors like costs — including how expensive health insurance is — and rates of insured and uninsured individuals. MoneyGeek also considered the health of each state’s population based on measures like rates of obesity and smoking, as well as mortality rates from conditions like diabetes. Finally, we analyzed the number of primary care providers and hospital beds and how much difficulty people had getting the care they needed.

The worst states score poorly on some or all of these factors and tend to have some or all of the following distinctions: the least healthy residents, the most expensive private health insurance, the highest proportion of uninsured residents and the most significant shortages of health care providers. The worst states also tend to spend the most on health care overall.


  • 15. Indiana
    Final Score: 54.6
    Indiana

    • 39Outcome Factor Rank (1st = Best)
    • 22Access Factor Rank (1st = Best)
    • 28Total Cost Factor Rank (1st = Lowest)

  • 14. South Dakota
    Final Score: 54.0
    South Dakota

    • 35Outcome Factor Rank (1st = Best)
    • 21Access Factor Rank (1st = Best)
    • 44Total Cost Factor Rank (1st = Lowest)

  • 13. Alabama
    Final Score: 53.0
    Alabama

    • 43Outcome Factor Rank (1st = Best)
    • 28Access Factor Rank (1st = Best)
    • 17Total Cost Factor Rank (1st = Lowest)

  • 12. Florida
    Final Score: 52.9
    Florida

    • 29Outcome Factor Rank (1st = Best)
    • 41Access Factor Rank (1st = Best)
    • 32Total Cost Factor Rank (1st = Lowest)

  • 11. Maine
    Final Score: 52.7
    Maine

    • 36Outcome Factor Rank (1st = Best)
    • 24Access Factor Rank (1st = Best)
    • 43Total Cost Factor Rank (1st = Lowest)

  • 10. Arizona
    Final Score: 52.7
    Arizona

    • 31Outcome Factor Rank (1st = Best)
    • 45Access Factor Rank (1st = Best)
    • 22Total Cost Factor Rank (1st = Lowest)

  • 9. Missouri
    Final Score: 49.9
    Missouri

    • 37Outcome Factor Rank (1st = Best)
    • 32Access Factor Rank (1st = Best)
    • 38Total Cost Factor Rank (1st = Lowest)

  • 8. Kentucky
    Final Score: 48.9
    Kentucky

    • 46Outcome Factor Rank (1st = Best)
    • 10Access Factor Rank (1st = Best)
    • 24Total Cost Factor Rank (1st = Lowest)

  • 7. New Mexico
    Final Score: 47.2
    New Mexico

    • 44Outcome Factor Rank (1st = Best)
    • 48Access Factor Rank (1st = Best)
    • 1Total Cost Factor Rank (1st = Lowest)

  • 6. Oklahoma
    Final Score: 45.6
    Oklahoma

    • 40Outcome Factor Rank (1st = Best)
    • 44Access Factor Rank (1st = Best)
    • 13Total Cost Factor Rank (1st = Lowest)

  • 5. Louisiana
    Final Score: 44.7
    Louisiana

    • 48Outcome Factor Rank (1st = Best)
    • 13Access Factor Rank (1st = Best)
    • 26Total Cost Factor Rank (1st = Lowest)

  • 4. Tennessee
    Final Score: 38.3
    Tennessee

    • 47Outcome Factor Rank (1st = Best)
    • 19Access Factor Rank (1st = Best)
    • 41Total Cost Factor Rank (1st = Lowest)

  • 3. Alaska
    Final Score: 33.7
    Alaska

    • 32Outcome Factor Rank (1st = Best)
    • 50Access Factor Rank (1st = Best)
    • 45Total Cost Factor Rank (1st = Lowest)

  • 2. Mississippi
    Final Score: 33.4
    Mississippi

    • 49Outcome Factor Rank (1st = Best)
    • 33Access Factor Rank (1st = Best)
    • 14Total Cost Factor Rank (1st = Lowest)

  • 1. West Virginia
    Final Score: 1.0
    West Virginia

    • 50Outcome Factor Rank (1st = Best)
    • 6Access Factor Rank (1st = Best)
    • 49Total Cost Factor Rank (1st = Lowest)

About the Author


expert-profile

Deb Gordon is author of The Health Care Consumer’s Manifesto (Praeger 2020), a book about shopping for health care, based on consumer research she conducted as a senior fellow in the Harvard Kennedy School’s Mossavar-Rahmani Center for Business and Government between 2017 and 2019. Her research and writing have been published in JAMA Network Open, the Harvard Business Review blog, USA Today, RealClear Politics, TheHill, and Managed Care Magazine. Deb previously held health care executive roles in health insurance and health care technology services. Deb is an Aspen Institute Health Innovators Fellow, and an Eisenhower Fellow, for which she traveled to Australia, New Zealand, and Singapore to explore the role of consumers in high-performing health systems. She was a 2011 Boston Business Journal 40-under-40 honoree, and a volunteer in MIT’s Delta V start-up accelerator, the Fierce Healthcare Innovation Awards, and in various mentorship programs. She earned a BA in bioethics from Brown University, and an MBA with distinction from Harvard Business School.