States ranked by healthcare in 2025. Quality varies dramatically across the United States, and where you live can determine how long you live, how easily you access care, and how much you pay for it. State health systems differ in hospital quality, physician availability, insurance coverage rates, maternal and infant health outcomes, costs, and health disparities. These differences matter when you’re choosing where to relocate for retirement, a new job, or to raise a family.
This guide ranks all 50 states by healthcare performance in 2025, drawing from the most recent data published by U.S. News & World Report, The Commonwealth Fund, and WalletHub. You’ll see which states consistently lead on access, quality, and outcomes, which states struggle with physician shortages and high costs, and what drives the gaps between the best and worst performers. Whether you’re prioritizing low insurance premiums, top-tier hospitals, or simply finding a doctor who accepts new patients, understanding state healthcare rankings helps you make informed decisions about where to live.
Key Points
- Hawaii, Massachusetts, and New Hampshire consistently rank as the top three states for healthcare in 2025, excelling in access to care, quality outcomes, and lower costs across multiple independent rankings.
- Mississippi, West Virginia, and Oklahoma consistently rank as the worst states for healthcare, struggling with physician shortages, high uninsured rates, poor maternal and infant health outcomes, and chronic disease prevalence.
- The top-performing states share common traits: higher Medicaid expansion adoption, more physicians per capita (250 to 350 per 100,000 residents), lower uninsured rates (under 5 percent), and stronger public health infrastructure.
- The bottom-performing states face physician shortages (150 to 200 physicians per 100,000 residents), higher uninsured rates (10 to 15 percent or more), limited hospital access in rural areas, and worse outcomes for maternal mortality, infant mortality, and chronic disease.
- Healthcare costs vary widely; states like Massachusetts and New York have excellent access and quality but higher premiums and out-of-pocket costs, while Southern states often have lower costs but worse outcomes and limited access.
- Medicaid expansion status remains one of the strongest predictors of healthcare performance; 10 states have not expanded Medicaid as of 2025, and most rank in the bottom half for overall healthcare access and outcomes.
How States Are Ranked: What the Data Measures
Three major organizations publish annual state healthcare rankings, each using different methodologies and emphases. Understanding how these rankings work helps you interpret what they mean for your specific healthcare needs.
U.S. News & World Report Best States Rankings
U.S. News evaluates all 50 states across 71 metrics in eight categories, with healthcare representing one major category. The healthcare rankings draw on data from the CDC, CMS (Centers for Medicare & Medicaid Services), and other federal sources, focusing on three subcategories: healthcare access (percentage insured, physician availability), healthcare quality (hospital ratings, preventable hospitalizations), and public health (life expectancy, disease prevalence, maternal and infant health).
This ranking emphasizes outcomes and infrastructure, making it useful for families prioritizing long-term health and access to quality hospitals.
The Commonwealth Fund State Scorecard
The Commonwealth Fund’s 2025 Scorecard evaluates states on 50 measures across health care access, quality, use of services, costs, health disparities, health outcomes, reproductive care, and women’s health. This scorecard explicitly tracks equity, measuring how different demographic groups (by race, income, insurance status) experience healthcare within each state.
The Commonwealth Fund ranking is particularly valuable for understanding disparities and reproductive health access, which became more important after the 2022 Dobbs decision changed abortion access state by state.
WalletHub Best & Worst States for Healthcare
WalletHub evaluates states on 44 metrics across three dimensions: cost (insurance premiums, out-of-pocket expenses, prescription costs), access (physicians per capita, hospital beds, dentist availability), and outcomes (life expectancy, disease rates, infant mortality). Each metric is graded on a 100-point scale, then weighted to produce an overall score.
WalletHub’s emphasis on cost makes it useful for retirees and families on fixed incomes who need affordable care, not just quality care.
Top 10 States for Healthcare in 2025
The best-performing states excel in multiple areas: high insurance coverage rates, abundant physician supply, strong hospital systems, low maternal and infant mortality, and effective public health infrastructure.
- 1. Hawaii (Best Overall)Ranks first in U.S. News. Has the longest life expectancy (80.7 years) and the lowest uninsured rate (under 3 percent) due to employer mandates. Challenges are cost and geographic isolation for specialized care.
- 2. MassachusettsPioneered near-universal coverage (model for ACA) with an uninsured rate below 3%. Has the highest concentration of world-class hospitals (MGH, Brigham). Tradeoff: highest average healthcare spending per capita.
- 3. New HampshireRanks first in WalletHub. Strong outcomes, high physician availability, and benefits from proximity to Boston’s medical infrastructure. Costs are moderate.
- 4. Rhode IslandExcels in preventive care and chronic disease management. State’s small size means most residents live within 30 minutes of a major hospital.
- 5. ConnecticutStrong hospital systems (Yale New Haven), high physician density, and excellent health outcomes. Costs are above average, and access can be uneven in rural areas.
- 6. MinnesotaAnchored by the Mayo Clinic. One of the lowest uninsured rates and leads in mental health access per capita. Costs are moderate.
- 7. IowaRobust primary care network and affordable premiums. Challenges include physician recruitment in rural counties and limited specialty care.
- 8. ColoradoYoung, active population with lower obesity rates. Strong hospital systems in Denver/Boulder, but rural and mountain communities face access challenges.
- 9. New YorkBenefits from world-class hospitals concentrated in NYC. Tradeoffs are extreme cost and geographic inequality (Upstate faces rural closures).
- 10. MarylandProximity to Johns Hopkins Hospital and universal hospital rate-setting which controls costs and reduces surprise billing. Access is strongest in Baltimore and D.C. suburbs.
Bottom 10 States for Healthcare in 2025
The worst-performing states struggle with physician shortages, high uninsured rates, limited hospital access, and poor outcomes for maternal and infant mortality, and chronic disease.
- 50. Mississippi (Worst Overall)Ranks last in all major rankings. Highest infant and maternal mortality rates, lowest life expectancy (74.4 years), and severe physician shortages. Has not expanded Medicaid, leaving over 15% uninsured.
- 49. West VirginiaHas the shortest life expectancy (73.9 years) and the highest rates of drug overdose deaths. Rural hospital closures and the opioid crisis strain systems despite Medicaid expansion.
- 48. OklahomaHigh uninsured rates (over 14 percent) and severe maternal health challenges. Physician shortages are acute, especially in rural counties.
- 47. ArkansasStruggles with access and outcomes. Has one of the highest obesity rates and poor maternal/infant health outcomes, despite Medicaid expansion.
- 46. South DakotaHas not expanded Medicaid. Faces significant rural access challenges, with many residents driving 50+ miles to a hospital. Native American population faces particularly poor outcomes.
- 45. KentuckyStruggles with chronic disease prevalence (highest smoking rates). Rural and Appalachian communities face significant barriers to care.
- 44. LouisianaStruggles with high maternal and infant mortality rates. Access remains limited in rural parishes despite Medicaid expansion.
- 43. MissouriOnly recently expanded Medicaid (2021), leaving lingering coverage gaps. Rural hospital closures and high chronic disease prevalence outside urban centers.
- 42. MontanaRanks low primarily due to rural access challenges. Geographically large with many rural counties having no hospital or limited primary care.
- 41. TennesseeHas not expanded Medicaid, leaving uninsured rates around 11 percent. Struggles with poor maternal/infant outcomes and severe physician shortages outside major cities.
State Healthcare Rankings: Top 10 and Bottom 10
| Rank | State | Key Strengths | Key Challenges |
|---|---|---|---|
| 1 | Hawaii | Longest life expectancy, lowest uninsured rate, strong outcomes | High costs, geographic isolation for specialty care |
| 2 | Massachusetts | World-class hospitals, near-universal coverage, excellent outcomes | Highest costs in nation, expensive premiums |
| 3 | New Hampshire | Low uninsured rate, high physician availability, strong outcomes | Moderate-high costs, limited diversity |
| 4 | Rhode Island | Low uninsured rate, strong maternal/infant health, good access | Moderate-high costs |
| 5 | Connecticut | Strong hospitals, high physician density, excellent outcomes | High costs, rural access gaps |
| 6 | Minnesota | Low uninsured rate, Mayo Clinic, strong mental health access | Cold climate health challenges |
| 7 | Iowa | Affordable premiums, strong primary care network | Rural physician shortages, limited specialty care |
| 8 | Colorado | Young, active population; good public health outcomes | Moderate-high costs, rural access challenges |
| 9 | New York | World-class NYC hospitals, comprehensive Medicaid | High costs, upstate rural hospital closures |
| 10 | Maryland | Johns Hopkins, rate-setting controls costs, low uninsured | Rural Eastern Shore access gaps |
| Rank | State | Key Challenges | What’s Missing |
|---|---|---|---|
| 50 | Mississippi | Highest infant/maternal mortality, severe physician shortages | No Medicaid expansion, rural hospital closures |
| 49 | West Virginia | Shortest life expectancy, opioid crisis, mental health gaps | Rural hospital closures, physician recruitment challenges |
| 48 | Oklahoma | High uninsured rate, poor maternal health outcomes | Late Medicaid expansion, rural access limited |
| 47 | Arkansas | High obesity/diabetes, rural hospital closures | Limited specialty care outside Little Rock |
| 46 | South Dakota | Rural physician shortages, poor outcomes on reservations | No Medicaid expansion, long travel distances |
| 45 | Kentucky | Highest smoking rates, high chronic disease prevalence | Rural/Appalachian access barriers |
| 44 | Louisiana | High maternal/infant mortality, rural access gaps | Limited care outside New Orleans/Baton Rouge |
| 43 | Missouri | Rural hospital closures, coverage gaps | Late Medicaid expansion, physician shortages |
| 42 | Montana | Geographic size creates access challenges | Physician recruitment difficult, long travel distances |
| 41 | Tennessee | High maternal/infant mortality, no Medicaid expansion | Rural hospital closures, high uninsured rate |
What Actually Matters for Your Healthcare Decision
Understanding state rankings is useful, but your personal healthcare needs should guide relocation decisions. Here’s how to translate rankings into actionable priorities.
If You Have Chronic Conditions
Prioritize states with strong specialty care, high physician density, and comprehensive insurance coverage. Massachusetts, Minnesota, Connecticut, and New York offer world-class hospitals and easy access to specialists. Avoid states with physician shortages and limited specialty care, especially if you need ongoing treatment for conditions like cancer, heart disease, or autoimmune disorders.
If You’re Planning to Have Children
Maternal and infant health outcomes vary dramatically by state. Massachusetts, New Hampshire, Vermont, and Minnesota have the lowest maternal and infant mortality rates in the nation. Mississippi, Louisiana, Georgia, and Arkansas have the highest. Access to obstetric care, neonatal intensive care units (NICUs), and midwifery services also varies significantly.
Check whether your target state has “maternity care deserts” (counties with no OB-GYN or hospital offering obstetric services). Rural states like South Dakota, Montana, and West Virginia face severe shortages, forcing pregnant women to travel hours for prenatal care and delivery.
If You’re on a Fixed Income or Uninsured
States that expanded Medicaid under the Affordable Care Act have lower uninsured rates and better access for low-income residents. As of 2025, ten states have not expanded Medicaid: Texas, Florida, Georgia, Tennessee, Mississippi, Alabama, South Carolina, Wyoming, Kansas, and Wisconsin (partial expansion). These states have significant coverage gaps, leaving millions of low-income adults without affordable insurance options.
States like Massachusetts, Vermont, and Hawaii offer robust public insurance programs and subsidies that make coverage more affordable for middle and lower-income residents.
If You’re Retiring
Medicare provides baseline coverage nationwide, but supplemental insurance (Medigap), Medicare Advantage plan availability, and access to physicians who accept Medicare vary by state. States with strong healthcare infrastructure (Massachusetts, Minnesota, Colorado, Hawaii) offer more Medicare Advantage plan options and better provider networks.
Also consider proximity to major medical centers for specialty care. Rural retirement destinations may offer low cost of living but limited access to advanced care when you need it. Check out our comprehensive article if you are thinking about retiring and moving to a new state.
If You’re Moving to a Rural Area
Rural healthcare access is a growing crisis. Over 130 rural hospitals have closed since 2010, and many rural counties have no hospital, no OB-GYN, and limited primary care. States with strong rural health networks (Minnesota, Iowa, Vermont) do better than states facing accelerating closures (Mississippi, Tennessee, Oklahoma).
Ask about telehealth availability, emergency response times, and nearest trauma centers. In some rural areas, the closest emergency room is 50+ miles away, which creates life-threatening delays for heart attacks, strokes, and severe injuries.
FAQ
Which state has the best healthcare in 2025?
Hawaii ranks first in U.S. News & World Report’s 2025 healthcare rankings, followed by Massachusetts and New Hampshire. Hawaii has the longest life expectancy in the nation (80.7 years), the lowest uninsured rate (under 3 percent), and strong health outcomes. Massachusetts offers world-class hospitals and near-universal coverage but at higher costs. New Hampshire balances quality, access, and moderate costs.
Which state has the worst healthcare in 2025?
Mississippi ranks last in all three major healthcare rankings. The state has the highest infant and maternal mortality rates in the nation, severe physician shortages, high chronic disease prevalence, and has not expanded Medicaid, leaving over 15 percent of the population uninsured. West Virginia, Oklahoma, and Arkansas round out the bottom four.
Does Medicaid expansion affect healthcare quality?
Yes, significantly. States that expanded Medicaid under the Affordable Care Act have lower uninsured rates, better maternal and infant health outcomes, fewer rural hospital closures, and improved access to preventive care. Non-expansion states (Texas, Florida, Georgia, Tennessee, Mississippi, Alabama, South Carolina, Wyoming, Kansas, Wisconsin) struggle with coverage gaps, higher uninsured rates, and worse health outcomes, especially for low-income residents.
How much do healthcare costs vary by state?
Healthcare costs vary dramatically. Massachusetts, New York, and Alaska have the highest premiums and out-of-pocket costs, often 20 to 40 percent above the national average. Southern and Midwest states like Mississippi, Arkansas, and Iowa have lower premiums, but access and quality are often worse. States like Minnesota and Colorado offer a balance of good quality and moderate costs.
What if I have a chronic condition and need specialty care?
Prioritize states with world-class hospitals and high physician density. Massachusetts, Minnesota, New York, Maryland (Johns Hopkins), and California offer the best specialty care networks. Avoid states with severe physician shortages like Mississippi, West Virginia, and rural parts of Montana and South Dakota, where accessing specialists requires long travel and extended wait times.
Are rural areas in top-ranked states better than cities in bottom-ranked states?
Not always. Rural healthcare access is a challenge even in top-performing states. Rural Vermont, upstate New York, and northern Minnesota face physician shortages and hospital closures despite their states ranking well overall. Urban areas in bottom-ranked states (like Jackson, MS, or Birmingham, AL) often have strong hospitals and better access than surrounding rural areas. Location within a state matters as much as the state ranking itself.
References
- U.S. News & World Report – Best States for Healthcare 2025
- The Commonwealth Fund – 2025 Scorecard on State Health System Performance
- WalletHub – Best & Worst States for Health Care 2025
- Advisory Board – The Best and Worst States for Healthcare 2025
- CDC – State Health Statistics
- Kaiser Family Foundation – Status of State Medicaid Expansion Decisions
- Centers for Medicare & Medicaid Services – Healthcare Data and Research
Healthcare rankings, costs, and access vary by specific location within states and change over time. The data here reflects 2025 rankings and general trends. Consult healthcare providers, insurance brokers, and local resources for personalized guidance when choosing where to live based on healthcare needs.
