Introduction: The Rising Cost of Care in 2025
Across the United States, the cost of healthcare continues to rise, placing growing financial pressure on patients, families, and providers alike. In 2025, many Americans are paying more for insurance premiums and out-of-pocket care while still facing barriers to consistent, affordable access.
But healthcare costs don’t rise equally everywhere. Depending on where you live, the price of coverage and the ease of accessing essential services can vary dramatically.
To gain clearer insights into healthcare affordability across the US, MedicaDepot analyzed current data from all 50 U.S. states, focusing on five core indicators: average monthly insurance premiums, annual deductibles, uninsured rates, Medicaid expansion status, and access to mental health care.
The results offer a clear, data-backed picture of healthcare affordability in 2025—and highlight the states doing the most (and the least) to make care accessible.
Key Findings at a Glance
- Hawaii ranks #1 for healthcare affordability in 2025, thanks to the state’s lowest deductibles, near-universal coverage, and strong public health infrastructure.
- Texas ranks last, with the highest uninsured rate in the country and limited access to both basic and mental healthcare services.
- Medicaid expansion and mental health access are critical factors—states that expanded Medicaid and offer stronger support for mental health consistently scored higher.
- Affordability varies dramatically by state. The highest-ranked state scored more than three times higher than the lowest-ranked state on our index.
Regional differences extend beyond core healthcare. Elective aesthetic treatments like Botox and lip fillers show wide cost variation depending on location, shaped by local pricing, demand, and state tax policies.
Healthcare Affordability by State: Heatmap
To visualize how affordability varies across the country, the map below shows how each of the 50 U.S. states scored on our 2025 Healthcare Affordability Index. Scores reflect a combination of insurance premiums, deductibles, uninsured rates, Medicaid expansion, and access to mental health services. The geographic differences are striking, highlighting how much location can influence both the cost and quality of care.
Top 10 Most Affordable States for Healthcare in 2025
Some states have taken clear, measurable steps to make healthcare more accessible and affordable for their residents. Whether through lower insurance premiums, reduced out-of-pocket costs, broader Medicaid access, or expanded mental health services, these states demonstrate how thoughtful policy and investment can ease the financial burden of care.
Below are the top 10 performers in our 2025 Healthcare Affordability Index—each offering a model for more equitable access to care.
1. Hawaii: The Nation’s Affordability Leader
Affordability Score: 89 | Avg. Premium: $493 | Deductible: $1,059 | Uninsured Rate: 3.9% | Medicaid Expansion: Yes
Hawaii ranks first in the country for healthcare affordability, offering the lowest average deductibles and one of the highest insurance coverage rates nationwide. With near-universal access, a long-standing Medicaid expansion policy, and consistent public health investment, Hawaii sets a benchmark for how affordability and access can work hand in hand.
2. Massachusetts: Low Uninsured Rates, High Mental Health Access
Affordability Score: 86 | Avg. Premium: $509 | Deductible: $1,555 | Uninsured Rate: 3.6% | Medicaid Expansion: Yes
Massachusetts combines strong state-level healthcare programs with exceptional access to mental health services. Its uninsured rate is among the lowest in the nation, and widespread Medicaid access helps make care more consistent and comprehensive, even for those facing higher-than-average deductibles.
3. Michigan: Affordable Coverage and Low Deductibles
Affordability Score: 83 | Avg. Premium: $452 | Deductible: $1,405 | Uninsured Rate: 6.2% | Medicaid Expansion: Yes
Michigan stands out for its low monthly insurance premiums and relatively modest deductibles. With Medicaid expansion firmly in place and a strong track record of insuring vulnerable populations, Michigan has built a healthcare environment where affordability is not an exception, but the norm.
4. Pennsylvania: A Balanced Approach to Coverage
Affordability Score: 81 | Avg. Premium: $461 | Deductible: $1,610 | Uninsured Rate: 7.2% | Medicaid Expansion: Yes
Pennsylvania’s strength lies in balance. The state maintains stable insurance premiums while expanding access to both basic and mental health services. Although deductibles are slightly above average, broader access and strong Medicaid participation help keep overall healthcare costs manageable.
5. Rhode Island: Strong Support, Low Premiums
Affordability Score: 79 | Avg. Premium: $425 | Deductible: $1,938 | Uninsured Rate: 6.0% | Medicaid Expansion: Yes
Despite higher-than-average deductibles, Rhode Island offers a notably affordable healthcare experience thanks to low premiums, strong Medicaid access, and excellent mental health support. For residents, the result is a healthcare system that’s both comprehensive and accessible.
6. Virginia: Low Premiums Drive Affordability
Affordability Score: 78 | Avg. Premium: $372 | Deductible: $1,752 | Uninsured Rate: 8.8% | Medicaid Expansion: Yes
Virginia offers some of the most affordable insurance premiums in the country, helping offset the impact of moderately high deductibles. With Medicaid expansion and improving mental health access, the state showcases how policy and pricing can work together to reduce cost barriers.
7. Oregon: High Access, Steady Costs
Affordability Score: 77 | Avg. Premium: $510 | Deductible: $1,776 | Uninsured Rate: 7.9% | Medicaid Expansion: Yes
Oregon’s affordability score is supported by excellent access to mental health services and a long-standing Medicaid expansion program. Although premiums and deductibles fall near the national average, the strength of its support systems helps keep overall affordability strong.
8. Maryland: Accessible Coverage at a Competitive Price
Affordability Score: 75 | Avg. Premium: $397 | Deductible: $1,806 | Uninsured Rate: 8.7% | Medicaid Expansion: Yes
Despite slightly elevated deductibles, Maryland offers low monthly premiums and consistent Medicaid access, making it one of the more affordable states for healthcare. The state’s commitment to expanding healthcare access across income groups continues to improve its affordability outlook.
9. Minnesota: High Deductibles, but Strong Safety Nets
Affordability Score: 75 | Avg. Premium: $406 | Deductible: $2,181 | Uninsured Rate: 5.6% | Medicaid Expansion: Yes
While Minnesota has one of the highest average deductibles in the top ten, its affordability score remains strong thanks to very low uninsured rates, reliable Medicaid access, and a growing focus on mental health. For residents, this creates a more secure and navigable path to care.
10. California: Broad Coverage in a High-Cost Environment
Affordability Score: 74 | Avg. Premium: $512 | Deductible: $1,490 | Uninsured Rate: 9.0% | Medicaid Expansion: Yes
California rounds out the top ten with a strong Medicaid foundation and moderate deductibles, though premiums are on the higher side. The state’s expansive public health efforts and widespread coverage options help mitigate the overall cost of care in one of the nation’s most populous—and economically varied—states.
10 Least Affordable States for Healthcare in 2025
While many states are working to improve healthcare affordability, others continue to face significant cost barriers. Whether due to high deductibles, minimal insurance coverage, lack of Medicaid expansion, or other metrics, the following ten states ranked lowest in our 2025 Healthcare Affordability Index. Each faces its own set of systemic challenges—making healthcare harder to afford and access for millions of Americans.
1. Texas: The Least Affordable State for Healthcare in 2025
Affordability Score: 29 | Uninsured Rate: 21.7% (highest in U.S.) | Medicaid Expansion: Not adopted
Texas ranks last in the nation, driven by a combination of high deductibles, limited access to care, and the country’s highest uninsured rate. Without Medicaid expansion and with minimal investment in mental health resources, affordability remains out of reach for many Texans.
2. Wyoming: High Premiums, Low Coverage
Affordability Score: 35 | Avg. Monthly Premium: $871 | Medicaid Expansion: Not adopted
Wyoming residents face some of the highest premiums in the country. Paired with limited Medicaid access and weak mental health support, the cost of care here is disproportionately high, especially for lower-income families and rural populations.
3. Tennessee: Deductibles Among the Nation’s Highest
Affordability Score: 36 | Avg. Deductible: $2,561 | Medicaid Expansion: Not adopted
With one of the highest average deductibles nationwide and no Medicaid expansion, Tennessee ranks among the bottom three. The state’s affordability gap is further widened by low access to preventive and mental health care services.
4. Georgia: High Costs, Low Access
Affordability Score: 37 | Avg. Deductible: $2,275 | Uninsured Rate: 16.1%
In Georgia, high out-of-pocket costs and limited access to coverage drive affordability issues across the state. With no Medicaid expansion and one of the highest uninsured rates in the nation, access to even basic care remains inconsistent.
5. Mississippi: Affordability Barriers Across the Board
Affordability Score: 40 | Uninsured Rate: 15.4% | Medicaid Expansion: Not adopted
Mississippi’s affordability score reflects a combination of structural barriers: high deductibles, limited Medicaid access, and very low mental health support. These overlapping issues leave many residents without viable pathways to care.
6. South Carolina: Limited Coverage, Limited Access
Affordability Score: 41 | Avg. Deductible: $2,295 | Mental Health Score: 4
South Carolina struggles with both coverage and care access. High deductibles, no Medicaid expansion, and minimal mental health infrastructure all contribute to its low affordability ranking in 2025.
7. Kansas: High Deductibles and No Expansion
Affordability Score: 44 | Avg. Deductible: $2,209 | Medicaid Expansion: Not adopted
Kansas’s lack of Medicaid expansion and elevated average deductibles create affordability hurdles, particularly for working-class residents. Even those with coverage may face substantial out-of-pocket expenses.
8. Vermont: Excellent Access, But Sky-High Costs
Affordability Score: 45 | Avg. Premium: $1,277 (highest in U.S.) | Avg. Deductible: $2,491
Despite excellent access to coverage and mental health services, Vermont ranks near the bottom due to cost. With the highest premiums in the country and steep deductibles, even insured residents may find care financially burdensome.
9. Florida: High Uninsured Rate and Limited Safety Nets
Affordability Score: 46 | Uninsured Rate: 15.5% | Medicaid Expansion: Not adopted
Florida’s affordability issues are tied to its high uninsured population and decision not to expand Medicaid. Premiums and deductibles are in the midrange, but access remains uneven, especially for low-income and underserved groups.
10. Alaska: High Prices, Sparse Access
Affordability Score: 47 | Avg. Monthly Premium: $1,045 | Uninsured Rate: 14.3%
Alaska faces some of the highest healthcare costs in the nation, with persistent gaps in coverage. Even with Medicaid expansion, provider shortages and geographic barriers mean that affordable, accessible care is still out of reach for many.
Full State Rankings: Healthcare Affordability Score (2025)
To offer a complete view of affordability across the U.S., we ranked all 50 states and D.C. using a data-driven score out of 100. This index reflects both the cost of care and access to key services, including insurance coverage and mental health support.
How the score works: Each state’s total is based on five indicators—average monthly premiums (30%), average annual deductibles (25%), uninsured rate (20%), Medicaid expansion status (15%), and mental health access (10%). All values were standardized to ensure comparability across categories. Medicaid expansion was treated as a binary factor: adopted states received full credit, while non-adopting states did not.
Why it matters: These rankings reveal where healthcare is most affordable—and where systemic barriers continue to drive up costs and limit care. By comparing states side-by-side, we aim to clarify a complex and deeply uneven landscape.
Aesthetic Care Costs Across the U.S.
While core healthcare affordability reflects essential access to insurance and treatment, elective procedures, such as Botox and dermal fillers, highlight a different type of regional divide. These treatments, often paid out-of-pocket, vary significantly in cost depending on location, demand, and tax policy.
To better understand this variation, we reviewed public pricing data from providers and aesthetic clinics across dozens of U.S. states. While these services are not factored into our affordability index, the data offers important context for patients and practitioners, especially in aesthetic medicine, where pricing transparency remains inconsistent.
- Botox averages $15 per unit in California, while Ohio offers some of the lowest pricing at $13 per unit—a nearly 15% difference.
- Lip filler costs vary even more: some Midwestern states offer prices up to $300 lower than coastal metros like New York or D.C.
- Sales tax is another factor: over a dozen states apply taxes to elective procedures, which can add to the total out-of-pocket cost for patients.
These figures offer a snapshot of how access to non-essential treatments, like injectables, can differ based on geography. While affordability is only one part of the equation, understanding cost variation helps providers position their offerings more competitively and gives patients a clearer picture of what to expect.
Note: Aesthetic pricing data is for illustrative purposes only and does not influence the main affordability ranking. All pricing is based on provider websites and public sources as of 2025.
Tips for Reducing Your Healthcare Costs
No matter where you live, there are practical steps individuals and families can take to reduce the burden of healthcare expenses without compromising on care. From navigating insurance options to finding local support resources, small changes can have a meaningful impact on annual costs.
Here are four smart, accessible ways to cut healthcare costs in 2025:
1. Check your eligibility for Medicaid or state-based subsidies
Even if you haven’t qualified in the past, changing income levels or new policy updates may make you eligible for free or low-cost coverage through your state’s health insurance marketplace.
2. Compare plans every year—even if you’re already insured
Plan prices, networks, and out-of-pocket costs change annually. Shopping around during open enrollment can uncover more affordable coverage or better benefits at a similar price.
3. Use telehealth for routine or non-urgent care
Many insurance plans now include virtual visits at reduced or no cost. Telehealth is especially useful for managing prescriptions, follow-ups, and minor health concerns without travel or long wait times.
4. Explore mental health support services in your community
Mental health resources are expanding in many regions, including free or sliding-scale therapy, support groups, and state-funded programs. Check with local clinics or nonprofit organizations for options.
Expert Insight
“Affordability isn’t just about what a plan costs on paper—it’s about how accessible care is once someone needs it,” says Dr. Elena Meyers, healthcare access researcher and advisor to MedicaDepot.
“Knowing what your plan covers, using preventive care, and accessing virtual services when appropriate can significantly reduce out-of-pocket spending over time.”
Supporting Access Through MedicaDepot’s Pro Bono Program
At MedicaDepot, we believe that access to care should not be determined by geography or income. That’s why we support licensed providers who volunteer their time to treat trauma-related skin concerns in underserved communities, providing these services at no cost to the patient. This initiative reflects our commitment to enhancing access to care, promoting equity, and improving the overall well-being of those in need.
Final Thoughts: A Clearer Picture of U.S. Healthcare in 2025
Healthcare affordability in the U.S. remains uneven, but insights like these help clarify this complex issue. By highlighting where access is most robust, we aim to empower patients, providers, and policymakers to collaborate toward a more equitable healthcare landscape. Want to see how your state compares? Scroll up to explore the full rankings.
Methodology & Sources
Methodology Summary:
Each state received a final affordability score out of 100, based on five key indicators:
- Average Monthly Premiums (30%)
- Average Annual Deductibles (25%)
- Uninsured Rate (20%)
- Medicaid Expansion Status (15%)
- Mental Health Access Score (10%)
All data was normalized on a 100-point scale. Medicaid expansion was treated as binary: adopted states received full credit; non-adopting states received none.
Sources:
- Kaiser Family Foundation (KFF): Provides data on premiums, uninsured rates, and Medicaid expansion.
- HealthMarkets: Offers insights on healthcare premiums and deductibles.
- U.S. Census Bureau: Supplies national and state-level data on health coverage.
- Medicaid.gov: Source for Medicaid expansion status by state.
- Mental Health America: Publishes state-by-state mental health care access data.
- State health departments: Provide relevant local data on healthcare accessibility.
Aesthetic Care Data Sources:
- RealSelf, CareCredit, and other platforms provide user-reported costs for aesthetic treatments like Botox and lip fillers, while state revenue departments offer tax rate information on medical services.
