States Where People Spend the Most & Least on Health Insurance

Health insurance premiums have climbed sharply in recent years, rising by 5% for individual plans and 6% for family plans in 2025 alone. While costs have risen nationwide, some states are far more expensive than others. In the costliest states, health insurance premiums can consume nearly 21% of the median household income, compared to less than 5% in the most affordable states.

To determine where health insurance is the biggest financial burden, WalletHub compared the average premiums for a silver health insurance plan offering a balance of moderate deductibles and relatively low premiums with median household income in all 50 states.

“Inflation has driven up health insurance premiums significantly in recent years, making it harder and harder for Americans to afford proper health care. Being without insurance is even more dangerous, though, as medical debt is one of the most common reasons people file for bankruptcy. People in certain states feel the pressure of high premiums more than others, as they can cost as much as 21% of the median income in some states and less than 5% in others.”

Chip Lupo, WalletHub Analyst

Understanding how to budget well can help you prepare for the high cost of health insurance. Regardless of how skillfully you maintain your budget, though, some people will need to pay more for health insurance just because of where they live.

Main Findings

States Where People Spend the Most & Least on Health Insurance

Note: *No. 1 = Highest Spending

In-Depth Look at the States That Spend the Most

West Virginia

West Virginians spend the most on health insurance, with average costs reaching nearly 21% of the median household income in the state. This is due to a combination of high premiums and low incomes.

The average monthly health care premium for a silver plan in West Virginia is $1,036, which is the third-highest in the country. At the same time, West Virginia has the second-lowest median household income, at $59,608.

Vermont

People in Vermont spend the second-most on health insurance as a percentage of their income. The average Vermonter shells out over 19% of their income on health insurance premiums. For comparison, residents of neighboring New Hampshire only spend around 5% of their income on insurance.

Vermont has the 19th-highest median household income in the country, at $81,203. However, the average monthly health care premium (for a silver plan) in the state is $1,289, the highest in the country, so people end up spending a disproportionate amount of their income on insurance.

Wyoming

Wyoming ranks third among the states where people spend the most on health insurance. The average health insurance premium is above 17% of the state’s median monthly income. While that’s significantly lower than the percentages spent in West Virginia and Vermont, it’s still very expensive.

Wyoming residents pay the second-highest monthly health insurance premiums in the country, at $1,089. These premiums consume such a large share of income that Wyomingites' median household income ($76,176), the 29th-highest, does little to offset the cost.

Ask the Experts

WalletHub turned to a panel of experts for additional advice on spending and budgeting when it comes to health insurance. Click on the experts below to read their bios and see their responses to the following key questions:

1. What tips do you have to reduce health insurance costs?
2. How important is budgeting when it comes to saving money on health insurance?
3. How is the current social and economic environment influencing household spending on health insurance?

Ask the Experts

Chris Douglas
Professor of Economics and Program Coordinator, Economics, Department of Social Sciences and Humanities, College of Arts, Sciences and Education - The University of Michigan-Flint
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Scott Thorne
Ph.D. – Instructor, Department of Marketing - Southeast Missouri State University
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Jeanette Landin
Ed.D., MBA – Professor, Professional Studies, Phi Theta Kappa and Golden Key Honors Societies Advisor, Landmark College
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Paul Shafer
Ph.D., Associate Professor, Department of Health Law, Policy, and Management; Co-Director, Medicaid Policy Lab - Boston University School of Public Health
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Melinda J.B. Buntin
Health Economist and a Bloomberg Distinguished Professor at the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Carey Business School
Read More

Joel E. Segel
Associate Professor of Health Policy and Administration, Penn State University, College of Health and Human Development
Read More

Money-Saving Health Insurance Tips

1. Make sure you have at least some coverage. As expensive as health insurance premiums can be, not having coverage can be far more costly if you experience a major medical emergency. Insurance plans have out-of-pocket maximums that put a hard limit on how much you can owe.
2. Budget well. Always include health insurance costs among the first things that you put into your budget, as coverage is essential. Then, set aside additional money each month until you have an emergency fund built that can cover 3-6 months’ worth of expenses. You can dip into your emergency fund when you have big medical expenses and need to pay money toward your deductible.
3. Consider high-deductible plans if you’re healthy. Plans with high deductibles tend to have lower monthly premiums. They essentially bank on you not needing much care during an average year. If you don’t have any big medical expenses, they can save you a lot of money. The tradeoff is that if you do have a medical emergency, you’ll have higher out-of-pocket costs than with lower-deductible plans.
4. Work at a job that covers your health insurance. Many Americans get their health insurance premiums covered through their employer. If yours doesn’t offer this benefit, you may want to consider switching jobs.
5. Stay on your parents’ insurance. Under the Affordable Care Act, young people can stay on their parents’ insurance policies until they’re at least 26 years old.
6. Use preventative care. Many insurance plans provide at least some types of preventative care, such as an annual physical exam and certain immunizations and screenings at no additional cost. Taking advantage of these free benefits can also help prevent future medical problems, which is good for both your health and your wallet.
7. Opt for in-network providers. Going to an in-network doctor will be much cheaper than one that’s outside your network. Plus, health care plans often have separate out-of-pocket maximums for in-network and out-of-network care.

Methodology

In order to identify the states that spend the most and least on insurance, WalletHub analyzed the premiums of a silver health insurance plan across the 50 states.

We adjusted these figures to the median monthly income in each state, then used the results to rank-order our sample.

 
Sources: Data used to create this ranking were collected as of June 11, 2026 from the U.S. Census Bureau and the Kaiser Family Foundation.

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