A new report from WalletHub shows that residents in the poorest U.S. states are spending a larger portion of their income on health care than people in wealthier states. The study found that Mississippi tops the list, with nearly 19% of the average household’s income going toward out-of-pocket medical costs. Maryland, on the other hand, has the lowest burden at just over 9%.
Out-of-pocket health care expenses — including doctor visits, prescriptions, and basic medications — have increased significantly in recent years. According to WalletHub, the average American now spends $1,425 annually on these costs, up from $763 two decades ago. This rise has outpaced inflation.
“Sharp increases in health care costs in recent years have made it difficult for some people to seek essential care,” said WalletHub analyst Chip Lupo. “Even in more affordable states, wages often fail to keep up, especially with inflation impacting nearly every part of household budgets.”
1. States Spending the Most on Health Care
WalletHub analyzed the average cost of visits to doctors, dentists, and optometrists, along with common medications like ibuprofen and Lipitor, across all 50 states. The findings show that lower-income states are carrying a heavier burden.
Mississippi residents spend 18.66% of their median household income on health care — the highest in the nation. The main reason: low wages. Mississippi’s average household income is just $54,915, the lowest in the U.S. So even if health services aren’t more expensive in absolute terms, they take up a much larger share of income.
Top 10 States by Share of Income Spent on Health Care:
- Mississippi: 18.66%
- Louisiana: 17.82%
- West Virginia: 16.24%
- Arkansas: 16.23%
- Oklahoma: 16.11%
- New Mexico: 15.78%
- Alaska: 15.65%
- North Carolina: 15.37%
- Alabama: 15.10%
- Kansas: 14.77%
2. States Spending the Least on Health Care
At the other end of the spectrum, states with higher median incomes are spending a smaller portion of their earnings on health care.
Maryland leads this group, with residents spending only 9.03% of their household income on out-of-pocket health expenses. Other wealthy states like New Jersey, Massachusetts, and Connecticut follow closely behind.
Top 10 States Spending the Least on Health Care:
- Maryland: 9.03%
- New Jersey: 9.40%
- Massachusetts: 10.00%
- Connecticut: 10.72%
- Rhode Island: 10.91%
- Colorado: 11.14%
- Virginia: 11.17%
- New Hampshire: 11.41%
- California: 11.43%
- Utah: 11.60%
3. What You Can Do to Save on Health Care
Jeff Helton, a health care expert at the University of Colorado Denver Business School, says the best way to reduce health care costs is to maintain a healthy lifestyle.
“Eat well, drink water, get regular sleep, and exercise. These simple habits can prevent expensive illnesses,” Helton told WalletHub.
He also recommends checking your health insurance coverage before making appointments or undergoing tests. Make sure the doctor, hospital, and any labs are in-network.
“Don’t skip your annual checkups,” Helton added. “Preventive care is one of the most effective ways to keep long-term health costs down.”
Bottom Line:
The WalletHub report underscores the impact of income inequality on health care access. Where you live — and how much you earn — can significantly affect how much you spend to stay healthy. In poorer states, health care takes up nearly one-fifth of household income, making even basic care a financial burden for many families.
