Best and Worst States for Health Care in 2023

With the Average American spending more than $12,900 per year on personal health care, the personal-finance website WalletHub today released its report on 2023’s Best & Worst States for Health Care.

In order to determine where Americans receive the highest-quality services at the best prices, WalletHub compared the 50 states and the District of Columbia across 44 key measures of health care cost, accessibility and outcome. The data set ranges from the average monthly insurance premium to physicians per capita to the share of insured population.

Health Care in California (1=Best; 25=Avg.):

  • 22nd – Avg. Monthly Insurance Premium
  • 47th – Hospital Beds per Capita
  • 24th – Physicians per Capita
  • 6th – Dentists per Capita
  • 23rd – % of Insured Adults
  • 14th – % of Insured Children
  • 51st – % of At-Risk Adults with No Routine Doctor Visit in Past Two Years
  • 32nd – % of Adults with No Dental Visit in Past Year
  • 1st – % of Medical Residents Retained

Expert Commentary
What tips do you have for a person looking to find the right balance between the cost of premium and level of coverage?

“Finding the right healthcare coverage is a challenging task. The first step of this process should always be to evaluate your healthcare needs and what your future healthcare needs may be. This may be difficult because so many people avoid or put off accessing healthcare out of fear of cost. Therefore, it is helpful to pretend that if there were no cost constraints, how often would you access primary care services? Framing your healthcare needs under these conditions better shapes what you are looking for in coverage. The second step is to compare plans according to your budget and healthcare needs. For example, my family and I consider how often we go to the doctor, if we anticipate any life events or changes in our health this year, and what we feel comfortable paying every month for insurance and copayments.”
— Maria ‘Mia’ Livaudais, Ph.D., MS – Assistant Professor, California State University-East Bay

“Typically, commercial health insurance plans with higher premiums will have a more generous level of coverage. Because health care is now so expensive, insurance plans that have low premiums, cover a wide range of physicians, and do not include high out-of-pocket costs are mostly a thing of the past. Instead, people need to choose between paying a lot for the coverage or paying less but covering more medical expenses themselves. If you do not have many current health care needs and can afford to save money, purchasing a plan with a higher deductible and lower premium can make sense for you. I would recommend that people who go this route use a plan that includes a health savings account (often abbreviated HSA) and put money into it. If you get health insurance through an employer, they may also help you fund that account. These accounts use pre-tax dollars, grow tax-free, and can be used (again, tax-free) for medical expenses. HSAs will follow you even when you leave the employer under which you originally opened the account. Once you have that nest egg of savings established through the HSA, you can afford to use a plan with lower premiums, knowing that you have a buffer in case of a major expense.”
— Betsy Q. Cliff, Ph.D. – Assistant Professor, University of Chicago

What are the most important steps Americans can take to minimize health-related expenditures? 

“Patients should encourage providers to prescribe generic drugs when possible and should also discuss their financial circumstances with their providers. Many drug companies offer prescription assistance programs for high-cost medications; while individuals are not guaranteed participation in such programs, they can dramatically lower costs for many newer, brand-name medications. In addition, lifestyle factors, such as exercising, smoking cessation, or losing weight, can reduce health risks and also lower an individual’s health care costs.”
— Robert B. Hackey, Ph.D. – Professor, Providence College

“The best steps Americans can take to minimize health-related expenditures are to stay healthy and manage chronic health conditions well. Health promotion and prevention strategies involve getting an annual physical, and obtaining regular screenings for early disease detection, such as cancer, diabetes, heart disease, and the like. Making good dietary choices by avoiding foods high in sodium, unsaturated and trans fats, refined sugars, and processed foods help. Participating in some form of exercise – at least 150 minutes per week for adults, according to the American Heart Association…is important; studies show that a sedentary lifestyle may lead to poor health and early death. Getting enough sleep, managing stress, and staying hydrated provide a holistic approach, along with diet and exercise lifestyle modifications.”
— Mary Lynne Knighten – Adjunct Professor; EL DNP Program Director, University of San Francisco

What are the major issues facing healthcare in 2023?

“There are several substantial issues in US healthcare at this time. The largest is COVID and its after-effects. We know that individuals are at risk of long-term COVID, and we are not sure what the long-term treatment and prognosis are for individuals with LC. We are also working our way through a delayed inflationary bump in healthcare costs. Millions of people are currently having their health insurance eligibility for Medicaid redetermined, and many will need to find new coverage. The temporary authorities, such as telehealth, are being reconsidered. Cost is always an issue in the US healthcare system, as is provider consolidation, which typically increases costs without improving quality.”
— David Anderson – Research Associate, Duke University

“Some of the significant issues facing healthcare in the US in 2023 include demanding more transparency from hospitals on the cost of medical bills. An initiative started by the New York Times that relied on consumers sending their medical bills depicted the glaring differences in medical expenses for the same procedures across hospitals, insurance, et cetera. Another aspect is checking the lobbying powers of stakeholders who obstruct legislation designed to make healthcare more accessible and equitable. Finally, aging in the US warrants more attention, as more public policies and programs are required to create the necessary infrastructure to support aging Americans who may not know when or how to seek medical care or how to afford it.”
— Sarah Ahmed, Ph.D. – Assistant Professor, Providence College

For the full report, please visit:



Image Sources

  • Healthcare: Shutterstock