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. Here are the top 10, with details on what makes them stand out.
1. Hawaii
Hawaii ranks first in U.S. News & World Report’s 2025 healthcare rankings, second in The Commonwealth Fund scorecard, and consistently high across all metrics. The state has the longest life expectancy in the nation (80.7 years), the lowest uninsured rate (under 3 percent), and strong healthcare access even in rural areas. Hawaii benefits from near-universal coverage through employer mandates enacted in the 1970s, a young and relatively healthy population, and lower rates of chronic disease.
The challenges in Hawaii are cost and geographic isolation. Healthcare is expensive (premiums and out-of-pocket costs run 20 to 30 percent higher than the national average), and specialized care often requires travel to Honolulu or the mainland. For routine care and overall health outcomes, Hawaii leads the nation.
2. Massachusetts
Massachusetts ranks second in U.S. News, first in The Commonwealth Fund scorecard, and fifth in WalletHub. The state pioneered near-universal health coverage in 2006 (the model for the Affordable Care Act) and maintains an uninsured rate below 3 percent. Massachusetts has the highest concentration of world-class hospitals (Massachusetts General, Brigham and Women’s, Boston Children’s) and some of the best health outcomes in the country.
The tradeoff is cost. Massachusetts has the highest average healthcare spending per capita in the nation, with premiums, deductibles, and out-of-pocket expenses significantly above the national average. Quality is exceptional, but you pay for it.
3. New Hampshire
New Hampshire ranks first in WalletHub’s 2025 list, third in The Commonwealth Fund scorecard, and consistently in the top five across rankings. The state has low uninsured rates (under 5 percent), high physician availability, and strong health outcomes including low infant and maternal mortality. New Hampshire also benefits from proximity to Boston’s medical infrastructure, giving residents access to top-tier specialists.
Healthcare costs in New Hampshire are moderate, lower than Massachusetts but higher than the national average. The state’s small population and relatively affluent demographics contribute to its strong performance.
4. Rhode Island
Rhode Island ranks fourth in U.S. News, fourth in The Commonwealth Fund, and second in WalletHub. The state has comprehensive Medicaid coverage, low uninsured rates, and strong maternal and infant health outcomes. Rhode Island also excels in preventive care utilization and chronic disease management.
Like Massachusetts, Rhode Island’s proximity to Boston provides access to specialized care. The state’s small size means most residents live within 30 minutes of a major hospital. Costs are moderate to high, but access and quality are excellent.
5. Connecticut
Connecticut ranks third in U.S. News and consistently in the top 10 across all rankings. The state has strong hospital systems (Yale New Haven Hospital, Hartford Healthcare), high physician density, and excellent health outcomes. Connecticut’s suburban and affluent population contributes to lower disease prevalence and higher utilization of preventive care.
Healthcare costs are above the national average, and access can be uneven in rural areas of the state. Urban and suburban residents have excellent care; rural residents face longer travel times.
6. Minnesota
Minnesota ranks third in WalletHub and consistently in the top 10 for healthcare access and quality. The state has one of the lowest uninsured rates in the nation (under 4 percent), strong public health infrastructure, and excellent maternal and child health outcomes. Minnesota also leads in mental health access, with more psychiatrists and counselors per capita than most states.
The Mayo Clinic in Rochester anchors Minnesota’s healthcare system, providing world-class specialty care. Costs are moderate, and access is strong even in rural areas due to coordinated care networks and telemedicine adoption.
7. Iowa
Iowa ranks fourth in WalletHub and performs well on access and cost metrics. The state has a robust primary care network, low uninsured rates (around 5 percent), and affordable premiums compared to coastal states. Iowa’s relatively homogeneous population and strong community health centers contribute to consistent outcomes across urban and rural areas.
Challenges include physician recruitment in rural counties and limited specialty care outside Des Moines and Iowa City. For primary care and routine needs, Iowa performs well at reasonable costs.
8. Colorado
Colorado ranks seventh in WalletHub, ninth in U.S. News, and consistently in the top 10 for public health outcomes. The state has a young, active population with lower obesity rates and higher life expectancy than the national average. Colorado has expanded Medicaid, keeping uninsured rates below 6 percent, and strong hospital systems in Denver and Boulder.
Healthcare costs in Colorado are moderate to high, especially along the Front Range. Rural and mountain communities face access challenges due to distance and physician shortages.
9. New York
New York ranks eighth in U.S. News and benefits from world-class hospitals (New York-Presbyterian, Mount Sinai, NYU Langone) concentrated in New York City and the Hudson Valley. The state has comprehensive Medicaid coverage, low uninsured rates (under 5 percent), and strong outcomes for cancer treatment, cardiac care, and maternal health.
The tradeoffs are cost and geographic inequality. Healthcare in New York City is among the best in the world, but expensive. Upstate New York faces rural hospital closures, physician shortages, and longer wait times. Statewide, premiums and out-of-pocket costs run 15 to 25 percent above the national average.
10. Maryland
Maryland ranks sixth in U.S. News and benefits from proximity to Johns Hopkins Hospital (consistently ranked the top hospital in the nation) and strong statewide hospital systems. Maryland has universal hospital rate-setting, which controls costs and reduces surprise billing. The state has low uninsured rates (under 6 percent) and strong maternal and infant health outcomes.
Healthcare costs are moderate to high, and access is strongest in Baltimore and the D.C. suburbs. Rural areas on the Eastern Shore face physician shortages and limited specialty care.
Bottom 10 States for Healthcare in 2025
The worst-performing states struggle with physician shortages, high uninsured rates, limited hospital access in rural areas, and poor outcomes for maternal mortality, infant mortality, and chronic disease. Many of these states have not expanded Medicaid, leaving significant coverage gaps.
50. Mississippi (Worst)
Mississippi ranks last in all three major healthcare rankings (U.S. News, WalletHub, and near-bottom in The Commonwealth Fund). The state has the highest infant mortality rate in the nation, the highest maternal mortality rate, one of the lowest life expectancies (74.4 years), and severe physician shortages (fewer than 200 physicians per 100,000 residents).
Mississippi has not expanded Medicaid, leaving over 15 percent of the population uninsured. Rural hospital closures have accelerated, leaving many counties without obstetric care or emergency services. Chronic disease prevalence (obesity, diabetes, heart disease) is among the highest in the country.
Healthcare costs are low compared to other states, but access and outcomes are poor. For anyone with chronic conditions, planning to have children, or needing specialty care, Mississippi presents significant challenges.
49. West Virginia
West Virginia ranks second-worst in U.S. News and struggles across all healthcare metrics. The state has the shortest life expectancy in the nation (73.9 years), the highest rates of drug overdose deaths, and severe shortages of mental health providers. Rural hospital closures have left large parts of the state without nearby emergency care.
West Virginia has expanded Medicaid, which keeps uninsured rates moderate (around 6 percent), but physician recruitment remains a major challenge. The state’s aging population, high poverty rates, and opioid crisis strain healthcare systems that were already under-resourced.
48. Oklahoma
Oklahoma ranks third-worst in U.S. News and near-bottom in The Commonwealth Fund scorecard. The state has high uninsured rates (over 14 percent), severe maternal health challenges (one of the highest maternal mortality rates in the nation), and limited rural healthcare access. Oklahoma expanded Medicaid only in 2021, and coverage gaps remain.
Physician shortages are acute, especially in rural counties where many residents drive over an hour to reach a hospital. Chronic disease prevalence is high, and preventive care utilization is low.
47. Arkansas
Arkansas ranks fourth-worst in U.S. News and struggles with access and outcomes. The state has expanded Medicaid, which lowered uninsured rates to around 8 percent, but rural hospital closures and physician shortages limit access. Arkansas has one of the highest obesity rates in the nation, high rates of diabetes and heart disease, and poor maternal and infant health outcomes.
Healthcare costs are low, but quality and access are limited outside Little Rock and Northwest Arkansas (Fayetteville-Bentonville area).
46. South Dakota
South Dakota ranks fifth-worst in U.S. News and faces significant rural access challenges. The state has not expanded Medicaid, leaving uninsured rates around 9 percent. Physician shortages are severe in rural counties, and many residents drive 50+ miles to reach a hospital.
South Dakota’s Native American population faces particularly poor health outcomes, with higher rates of diabetes, heart disease, and infant mortality than the state average. Healthcare infrastructure on reservations is under-resourced and underfunded.
45. Kentucky
Kentucky ranks sixth-worst in U.S. News and struggles with chronic disease prevalence (highest smoking rates in the nation, high obesity and diabetes). The state expanded Medicaid, which lowered uninsured rates to around 6 percent, but physician shortages and rural hospital closures limit access.
Kentucky has pockets of excellence (University of Kentucky Hospital, Norton Healthcare in Louisville), but rural and Appalachian communities face significant barriers to care.
44. Louisiana
Louisiana ranks seventh-worst in U.S. News and struggles with maternal mortality (one of the highest rates in the nation), infant mortality, and chronic disease. The state expanded Medicaid in 2016, which lowered uninsured rates to around 8 percent, but access remains limited in rural parishes.
Louisiana has strong hospital systems in New Orleans and Baton Rouge (Ochsner Health, LSU Health), but residents outside urban areas face long travel times and physician shortages.
43. Missouri
Missouri ranks eighth-worst in U.S. News and only recently expanded Medicaid (2021), leaving lingering coverage gaps. Uninsured rates hover around 9 percent, and rural hospital closures have accelerated. Missouri has strong healthcare systems in St. Louis and Kansas City, but residents in rural areas face limited access and long wait times.
Chronic disease prevalence is high, and preventive care utilization is low outside urban centers.
42. Montana
Montana ranks ninth-worst in U.S. News, primarily due to rural access challenges. The state is geographically large with a small population (just over 1 million), making physician recruitment and hospital viability difficult. Many rural counties have no hospital, no OB-GYN, and limited primary care.
Montana expanded Medicaid, keeping uninsured rates moderate (around 7 percent), but distance and weather create barriers to care. Residents in eastern Montana often drive 100+ miles to reach a hospital.
41. Tennessee
Tennessee rounds out the bottom 10 in U.S. News and struggles with maternal mortality, infant mortality, and chronic disease. The state has not expanded Medicaid, leaving uninsured rates around 11 percent. Rural hospital closures have accelerated, and physician shortages are severe outside Nashville, Memphis, and Knoxville.
Healthcare costs are moderate, but access and outcomes are poor, especially for rural and low-income residents.
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.
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.
