Health care benefits costs
New Hampshire is the best state for health care, with the fourth-lowest out-of-pocket spending in the country, according to the 2025 Best and Worst States for Health Care report from WalletHub.
“Residents also have the lowest average monthly health insurance premium at around $470,” WalletHub analyst Chip Lupo said. “To top things off, New Hampshire has the fifth-lowest share of residents with coronary heart disease, third-lowest prevalence of strokes and the second-lowest prevalence of type-2 diabetes in the country.”
Rhode Island, Minnesota, Iowa and Massachusetts round out the top five states. The bottom five states are Texas, Georgia, Alabama, Alaska and Mississippi. The rankings compared all 50 states and the District of Columbia across 44 key measures of health care cost, accessibility and outcome, ranging from the average monthly insurance premium to physicians per capita to the share of insured population.
“Health care has two crucial components, cost and quality,” Lupo said. “The best health care in the nation isn’t helpful if it bankrupts the people who try to get it, and cheap health care isn’t worth paying for if it provides subpar or ineffective treatment. Therefore, the best states for health care are those that make high-quality care affordable, on top of providing many options for doctors and making insurance easily accessible.”
Employers, much like states, face the challenge of finding the proper balance between the cost of premiums and level of coverage provided.
“Purchasing coverage requires individuals to understand their health care needs for the coming year,” said Michael Stowe, Ph.D., chair of health care programs at the University of St. Francis. “They want to ensure that care is covered when needed but not purchase excessive plans where benefits do not apply to their situation.
“High-deductible plans are growing popular to help balance cost and utilization between patient and insurer. These can be good options for people with cash resources or access to a health savings account, so they can pay for the basic routine care but are covered in case of unforeseen added costs like hospitalization. Individuals who utilize high amounts of care, like those with chronic conditions, may benefit from a more comprehensive level of coverage.”
Employers and workers can take several steps to hold the line on costs, said Nancy Chan Fent, a professor at Suffolk University.
“Contributing to health savings accounts or flexible spending accounts provides tax savings while covering out-of-pocket medical expenses,” she said. “Comparing costs for procedures, using urgent care instead of emergency rooms when appropriate and reviewing medical bills for accuracy are also practical strategies. Maintaining a healthy lifestyle remains one of the most effective ways to lower long-term health care spending.”
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