Healthcare costs are eating away the finances of Americans, and it’s likely to get worse.
Healthcare costs are eating away the finances of Americans, and it’s likely to get worse.
Enrollment in the federal health insurance marketplace reached a record high this year. The increase was likely due to increased premium tax credits for the coverage and extended eligibility that was part of the American Rescue Plan signed by President Joe Biden in 2021, according to the Urban Institute.
But the tax credits are due to expire at the end of this year. The Urban Institute says that if the enhancements are not extended, 3.1 million more people will be uninsured in 2023, and enrollees who remain will spend hundreds of dollars more per person on premiums.
And premiums are just the start. Many U.S. households do not have enough money available to cover the cost of a typical deductible in a private health plan, according to an analysis by the Kaiser Family Foundation. About a third of single-person households with private insurance in 2019 could not pay a $2,000 bill, and half could not pay a $6,000 bill, according to KFF.
And that leads to medical debt. Nearly 1 in 10 adults – or roughly 23 million people – owe medical debt, according to KFF. This includes 11 million who owe more than $2,000 and 3 million people who owe more than $10,000.
Scroll to Continue
The costs are eating up Americans’ paychecks. Premium contributions and deductibles totaled 11.6% of median income in 2020, up from 9.1% in 2010, according the Commonwealth Fund.
Americans spend more on health care than any other nation by far—$12,318 per capita, according to the OECD; that’s $4,935 more than the next most expensive country, Germany, which spends $7,383 per capita.
Health care affordability isn’t just an issue for those who pay healthcare on their own or through the marketplace, it’s becoming a burden even to large employers who provide the benefit to their workers. A 2021 survey by Kaiser Family Foundation found that overall, large employers find healthcare costs excessive and that that the cost of providing health benefits to employees will become unsustainable in the next five to 10 years. Some 85% of respondents believe that there will need to be greater government roles in providing coverage and containing costs. One respondent noted in a follow-up interview, “if it’s not the government stepping in, who would it be?”
This list shows the average cost of health insurance in each of the 50 states, ranging from $831 a month in West Virginia, the most expensive state, to $309 a month in the cheapest state.
The figures come from Value Penguin, which aggregated premium rates from the Centers for Medicare & Medicaid Services site. Using the rates and premiums for each plan, averages were calculated for a variety of variables such as metal tier, family size or county. Average costs per state are calculated from a silver plan for 40-year-old.
1. West VirginiaMonthly cost: $831Annual cost: $9,972Difference from national average: +53.72%A number of factors contribute to the reason some states cost more than others. One of them is called “silver loading,” where insurers raise the premiums they charge for silver plans to offset the now-uncompensated cost of providing cost-sharing reductions. You can read more about silver loading at Brookings.
West Virginia is one of three states that doesn’t allow silver loading, and this is one of the reasons premiums are high here, as explained by the West Virginia Center on Budget and Policy. They also show how much more West Virginians will pay if the American Rescue Plan tax credits are allowed to expire at the end of the year.
2. South DakotaMonthly cost: $811Annual cost: $9,732Difference from national average: +50.02%Andrew Farkas/Wikipedia
3. WyomingMonthly cost: $764Annual cost: $9,168Difference from national average: +41.32%Shutterstock
4. VermontMonthly cost: $760Annual cost: $9,120Difference from national average: +40.58%5. LouisianaMonthly cost: $728Annual cost: $8,736Difference from national average: +34.67%6. AlaskaMonthly cost: $715Annual cost: $8,580Difference from national average: +32.26%7. New YorkMonthly cost: $713Annual cost: $8,556Difference from national average: +31.89%8. NebraskaMonthly cost: $685Annual cost: $8,220Difference from national average: +26.71%9. OklahomaMonthly cost: $635Annual cost: $7,620Difference from national average: +17.46%10. North CarolinaMonthly cost: $634Annual cost: $7,608Difference from national average: +17.28%11. MissouriMonthly cost: $620Annual cost: $7,440Difference from national average: +14.69%12. FloridaMonthly cost: $585Annual cost: $7,020Difference from national average: +8.21%13. AlabamaMonthly cost: $579Annual cost: $6,948Difference from national average: +7.1%14. NevadaMonthly cost: $578Annual cost: $6,936Difference from national average: +6.92%15. ArizonaMonthly cost: $577Annual cost: $6,924Difference from national average: +6.73%16. TexasMonthly cost: $575Annual cost: $6,900Difference from national average: +6.36%17. ConnecticutMonthly cost: $564Annual cost: $6,768Difference from national average: +4.33%18. UtahMonthly cost: $563Annual cost: $6,756Difference from national average: +4.14%Shutterstock
19. IllinoisMonthly cost: $556Annual cost: $6,672Difference from national average: +2.85%20. DelawareMonthly cost: $555Annual cost: $6,660Difference from national average: +2.66%21. CaliforniaMonthly cost: $537Annual cost: $6,444Difference from national average: -0.67%21. New JerseyMonthly cost: $537Annual cost: $6,444Difference from national average: -0.67%Sean Pavone/Shutterstock
23. MassachusettsMonthly cost: $535Annual cost: $6,420Difference from national average: -1.04%24. KansasMonthly cost: $534Annual cost: $6,408Difference from national average: -1.22%25. IowaMonthly cost: $533Annual cost: $6,396Difference from national average: -1.41%Ken Wolter / Shutterstock
26. North DakotaMonthly cost: $524Annual cost: $6,288Difference from national average: -3.07%Checubus / Shutterstock
27. IdahoMonthly cost: $516Annual cost: $6,192Difference from national average: -4.55%28. WisconsinMonthly cost: $514Annual cost: $6,168Difference from national average: -4.92%29. VirginiaMonthly cost: $512Annual cost: $6,144Difference from national average: -5.29%Shutterstock
30. MississippiMonthly cost: $511Annual cost: $6,132Difference from national average: -5.48%31. TennesseeMonthly cost: $508Annual cost: $6,096Difference from national average: -6.03%Shutterstock
32. PennsylvaniaMonthly cost: $498Annual cost: $5,976Difference from national average: -7.88%Shutterstock
33. HawaiiMonthly cost: $490Annual cost: $5,880Difference from national average: -9.36%aceshot1 / Shutterstock
33. OhioMonthly cost: $490Annual cost: $5,880Difference from national average: -9.36%Raisa Nastukova / Shutterstock
35. New MexicoMonthly cost: $480Annual cost: $5,760Difference from national average: -11.21%36. MontanaMonthly cost: $479Annual cost: $5,748Difference from national average: -11.39%37. KentuckyMonthly cost: $478Annual cost: $5,736Difference from national average: -11.58%38. OregonMonthly cost: $475Annual cost: $5,700Difference from national average: -12.13%Shutterstock
39. MaineMonthly cost: $465Annual cost: $5,580Difference from national average: -13.98%Shutterstock
40. WashingtonMonthly cost: $443Annual cost: $5,316Difference from national average: -18.05%Shutterstock
41. South CarolinaMonthly cost: $436Annual cost: $5,232Difference from national average: -19.35%Shutterstock
42. IndianaMonthly cost: $433Annual cost: $5,196Difference from national average: -19.90%RozenskiP / Shutterstock
43. ArkansasMonthly cost: $419Annual cost: $5,028Difference from national average: -22.49%44. Rhode IslandMonthly cost: $413Annual cost: $4,956Difference from national average: -23.60%45. MichiganMonthly cost: $410Annual cost: $4,920Difference from national average: -24.16%46. ColoradoMonthly cost: $409Annual cost: $4,908Difference from national average: -24.34%Ken Wolter / Shutterstock
47. MinnesotaMonthly cost: $389Annual cost: $4,668Difference from national average: -28.04%Shutterstock
48. MarylandMonthly cost: $365Annual cost: $4,380Difference from national average: -32.48%49. New HampshireMonthly cost: $360Annual cost: $4,320Difference from national average: -33.41%Shutterstock
50. GeorgiaMonthly cost: $309Annual cost: $3,708Difference from national average: -42.84%See this list at ValuePenguin.com.