Map Shows Where Americans Spend the Most on Health Care in 2026

Americans are devoting a growing share of their income to health care, with costs rising sharply over the past two decades. In some states, the burden is significantly heavier than in others, according to a new WalletHub report.

The latest WalletHub ranking finds that residents in one state spend more than 10 percent of their income on medical care, compared to roughly half that in the least expensive states.

Nationwide, average annual out-of-pocket health care spending has climbed from $811 to $1,514 over the past 20 years, outpacing inflation and putting additional pressure on household budgets.

Why It Matters

Rising health care costs are increasingly shaping financial decisions for millions of Americans, with some forced to delay or forgo care altogether.

Even in states where prices are relatively lower, incomes are often insufficient to offset the financial strain, particularly amid broader inflation affecting housing and essential food costs.

What To Know

The WalletHub report ranked all 50 states based on the share of median household income spent on essential medical services and medications.

Top 10 States Where Americans Spend the Most on Health Care:

• Alaska - 10.08 percent
• Oregon - 9.32 percent
• Maine - 9.30 percent
• Mississippi - 9.18 percent
• West Virginia - 9.14 percent
• New Mexico - 9.07 percent
• North Carolina - 8.78 percent
• Montana - 8.62 percent
• South Dakota - 8.60 percent
• Louisiana - 8.13 percent

At the other end of the spectrum, the states where health care consumes the smallest share of income include:

States Where Americans Spend the Least on Health Care:

• Utah - 5.11 percent
• Virginia - 5.62 percent
• California - 5.64 percent
• New Jersey - 5.81 percent
• Nevada - 5.87 percent

New York ranks in the middle of the pack at 15th overall, with residents spending about 7.98 percent of their income on health care.

What's Driving the Differences

The data show that high spending is not always tied to lower incomes; often, it reflects steep medical costs.

"Sharp increases in health care costs in recent years have made it difficult for some people to seek essential care," WalletHub writer and analyst Chip Lupo said in the report. "Even in states with lower-than-average health care prices, residents' incomes may not be enough to keep up with the cost, especially since virtually every part of Americans' budgets have been impacted by inflation over the past few years."

Alaska: Highest Burden Nationwide

Alaska tops the list, with residents spending as much as 10.1 percent of their median income on health care.

The report attributes this to some of the highest prices in the country for doctor visits and medications. Even though Alaska's median income ranks relatively high nationally, elevated costs push overall spending above that of other states.

Oregon: High Prices Drive Costs

Oregon ranks second, with about 9.3 percent of income going toward health care.

However, that burden appears to be driven more by high service costs, including doctor visits and optometry care, than by lower wages.

"These aren’t the poorest states. They’re states with aging populations, rural access problems, and limited insurance market competition driving costs through the roof," Michael Ryan, a finance expert and the founder of MichaelRyanMoney.com, told Newsweek.

Maine: Lower Income Plays a Role

Maine, the third-highest state, had relatively high medical prices and lower-than-average household earnings, further increasing the share of income residents devote to care. As the 13th most expensive state for dental visits, Maine also had a median household income of only $74,733.

How the Rankings Were Calculated

The WalletHub report evaluated five key components of medical spending across all states:

• Doctor visits
• Dentist visits
• Optometrist visits
• Prescription costs for ibuprofen
• Prescription costs for insulin glargine

Researchers then compared the combined cost of those services with each state's median household income to determine the financial burden of care.

Data was collected as of April 30 from the Council for Community and Economic Research and the U.S. Census Bureau.

"These percentages are averages. They hide the people at the bottom of every state’s income distribution who are paying 20, 25, 30 percent of what they actually earn on healthcare," Ryan said. "Those families don’t show up in the headline number."

What Americans Can Do To Lower Health Care Costs

While geography can play a major role in health care costs, there are also many things Americans can do to lower expenses.

By maintaining health insurance coverage and using covered preventive care services, you can often reduce your long-term spending. Finance experts also encourage patients to build an emergency fund and take advantage of tax-advantaged health savings accounts when possible.

"Many states have dealt with a declining number of healthcare facilities which equates to less competition and typically more miles residents have to travel," Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, told Newsweek.

"What is most evident in these findings is someone being insured doesn’t tell the full story. There are more factors going into health care costs than being insured or not, and these need to be considered when budgeting for medical expenses."

What Happens Next

Widening regional disparities in health care affordability could become a major policy focus as costs continue to rise.

Without changes to pricing, insurance coverage, or income growth, Americans in high-cost states may continue to see an increasing share of their income consumed by essential medical care.

"The reality is that the industry will likely continue to consolidate; competition will remain sparse, and there is very little on the horizon suggesting prices are going to move meaningfully lower," Kevin Thompson, the CEO of 9i Capital Group and the host of the 9innings podcast, told Newsweek. "Healthcare inflation is not just about insurance premiums, it’s embedded throughout the entire system and ultimately finds its way back to the consumer."

2026 NEWSWEEK DIGITAL LLC.

This story was originally published June 1, 2026 at 12:08 PM.