The state of healthcare across the US

For the study, West Health and Gallup surveyed 19,535 U.S. adults about their experiences with healthcare cost, quality, and access between June 9 and Aug. 25.

The top three states for overall healthcare experience were Iowa, Massachusetts, and the District of Columbia. Meanwhile, the bottom three states for overall healthcare experience were Alaska, Nevada, and New Mexico. 

However, even among states in the top 10, respondents generally rated their local healthcare systems as satisfactory ("C") or poor ("D"). Healthcare costs received the lowest grades, with mostly Ds. The highest grade given was a B- in healthcare quality for Massachusetts. Overall, respondents gave America a "C" grade for its healthcare system, with healthcare quality and access earning a C+ and healthcare costs earning a D+.

According to the survey, healthcare costs continue to be a significant concern for many Americans. Currently, only 51% of U.S. adults believe healthcare is affordable and accessible — a 10-percentage point decrease from 2022. Older adults ages 65 and older were more likely to say that healthcare was affordable compared to younger adults.

How do high- and low-ranking states compare?

According to West Health and Gallup, there are significant discrepancies between the top- and the lowest-ranking states.

When it comes to healthcare costs, high-performing states are more likely to minimize patients' financial burden. For example, 12% of respondents in Iowa (ranked no. 1) said they were unable to afford a prescription in the last three months compared to 36% in Mississippi (ranked no. 44).

Similarly, 18% of respondents in Massachusetts (ranked no. 2) said a household member skipped medical treatment due to cost compared to 46% in Mississippi.  

Respondents in top-ranked states are also more likely to say their healthcare provider ensures they receive all recommended screenings and evaluations, with 78% of respondents in Massachusetts (ranked no. 2) and Rhode Island (ranked no. 4) saying so, compared to 59% in Oregon (ranked no. 41) and Wyoming (ranked no. 39).

Top-ranked states also had fewer barriers to healthcare access, including difficulties finding providers or long wait times. 

Overall, West Health and Gallup said the study shows that "all states — even those at the top — have room for improvement" and that "[u]nderstanding these state-level differences is critical for policymakers aiming to address the growing challenges in healthcare access, affordability and quality."