The U.S. health care system operates differently from many others in the world, characterized by high costs for the individual. In fact, it is the higher prices of medication, treatments, and hospital procedures that make the U.S. spend more on health care than any other developed country in the world, a 2019 Johns Hopkins report found.
Though expensive, the health care cost is to a large extent covered by the government. In 2019, 29.0% of all health-related spending in the U.S. was paid for by the federal government. Slightly less — 28.4% — came from households. State and local governments covered 16.1% of the total cost.
In 2018, the latest year for which state and local data is available, state governments spent $885 billion on health care, or $2,696 per person. Due to different budget priorities and needs, local government health care spending varies considerably by state.
To determine how much each state spends on your health, 24/7 Tempo reviewed the detailed health care expenditures by state governments provided by the U.S. Census Bureau’s 2018 Annual Survey of State and Local Finances. Per-capita health care spending ranges from less than $1,100 to more than $3,600.
States allocate between 17% and 39% of their total budgets to health care costs. The major categories of health spending at the state level include partial Medicaid coverage, state-run hospitals and university medical schools, and finally other health expenses and programs addressing needs such as community wellness, substance abuse, health inspection, and pollution control.
In every state, the largest portion of overall health care spending goes towards public welfare programs. These include Medicare and Medicaid, two government-funded health insurance programs that offer coverage to the elderly, the disabled, and people with low incomes.
On a global scale, greater health care spending appears to drive up overall life expectancy. In the United States, however, the relationship between spending and health outcomes appears to be more complicated. The COVID-19 pandemic lowered the life expectancy at birth in many states — here is where life expectancy was declining even before the pandemic.
Click here to see what your state spends on your health
To identify how much each state spends on your health, 24/7 Tempo reviewed the detailed health care expenditures by state governments provided by the U.S. Census Bureau’s 2018 Annual Survey of State and Local Finances.
State spending on health in 2018 consists of three components: each state’s public health expenditure, hospital expenditure, and welfare payments made directly to private vendors for medical assistance and hospital and health care.
State public health expenditure includes all public health activities except provision of hospital care. Hospital expenditure includes the construction and operation of hospitals by each state government and payments to privately operated hospitals.
Per capita spending was calculated using the total of each state’s expenditure in these areas and 2019 annual estimates from the U.S. Census Bureau’s 2019 American Community Survey (ACS). The shares of the population 65 and older, those living with a disability, and those with health insurance also came from the ACS and are for 2019
50. South Dakota
> State spending on health in 2018: $1,046 per capita
> Health spending as share of all state spending in 2018: 17.7% — 3rd lowest
> Total state health budget: $925.7 million
> Population 65 and older: 17.4% — 21st highest
> Population with a disability: 12.6% — 21st lowest
> Adults without health insurance: 10.2% — 13th highest
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49. Nebraska
> State spending on health in 2018: $1,203 per capita
> Health spending as share of all state spending in 2018: 20.9% — 7th lowest
> Total state health budget: $2.3 billion
> Population 65 and older: 16.1% — 15th lowest
> Population with a disability: 12.0% — 17th lowest
> Adults without health insurance: 8.3% — 23rd highest
48. Georgia
> State spending on health in 2018: $1,262 per capita
> Health spending as share of all state spending in 2018: 26.0% — 18th lowest
> Total state health budget: $13.4 billion
> Population 65 and older: 14.3% — 4th lowest
> Population with a disability: 12.6% — 21st lowest
> Adults without health insurance: 13.4% — 3rd highest
47. Nevada
> State spending on health in 2018: $1,272 per capita
> Health spending as share of all state spending in 2018: 22.5% — 10th lowest
> Total state health budget: $3.9 billion
> Population 65 and older: 16.2% — 17th lowest
> Population with a disability: 12.3% — 19th lowest
> Adults without health insurance: 11.4% — 8th highest
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46. Connecticut
> State spending on health in 2018: $1,371 per capita
> Health spending as share of all state spending in 2018: 17.4% — 2nd lowest
> Total state health budget: $4.9 billion
> Population 65 and older: 17.6% — 16th highest
> Population with a disability: 11.9% — 16th lowest
> Adults without health insurance: 5.9% — 11th lowest
45. Idaho
> State spending on health in 2018: $1,380 per capita
> Health spending as share of all state spending in 2018: 23.6% — 11th lowest
> Total state health budget: $2.5 billion
> Population 65 and older: 16.2% — 16th lowest
> Population with a disability: 13.7% — 19th highest
> Adults without health insurance: 10.8% — 12th highest
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44. New Hampshire
> State spending on health in 2018: $1,450 per capita
> Health spending as share of all state spending in 2018: 22.1% — 9th lowest
> Total state health budget: $1.9 billion
> Population 65 and older: 18.6% — 9th highest
> Population with a disability: 13.1% — 24th lowest
> Adults without health insurance: 6.3% — 13th lowest
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43. Florida
> State spending on health in 2018: $1,451 per capita
> Health spending as share of all state spending in 2018: 32.0% — 14th highest
> Total state health budget: $31.2 billion
> Population 65 and older: 20.9% — 2nd highest
> Population with a disability: 13.7% — 19th highest
> Adults without health insurance: 13.2% — 4th highest
42. Illinois
> State spending on health in 2018: $1,504 per capita
> Health spending as share of all state spending in 2018: 20.6% — 6th lowest
> Total state health budget: $19.1 billion
> Population 65 and older: 16.1% — 14th lowest
> Population with a disability: 11.5% — 10th lowest
> Adults without health insurance: 7.4% — 21st lowest
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41. Texas
> State spending on health in 2018: $1,509 per capita
> Health spending as share of all state spending in 2018: 29.0% — 22nd highest
> Total state health budget: $43.8 billion
> Population 65 and older: 12.9% — 3rd lowest
> Population with a disability: 11.5% — 10th lowest
> Adults without health insurance: 18.4% — the highest
40. North Carolina
> State spending on health in 2018: $1,588 per capita
> Health spending as share of all state spending in 2018: 27.3% — 22nd lowest
> Total state health budget: $16.7 billion
> Population 65 and older: 16.7% — 23rd lowest
> Population with a disability: 13.2% — 25th highest
> Adults without health insurance: 11.3% — 10th highest
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39. Tennessee
> State spending on health in 2018: $1,623 per capita
> Health spending as share of all state spending in 2018: 33.0% — 10th highest
> Total state health budget: $11.1 billion
> Population 65 and older: 16.7% — 22nd lowest
> Population with a disability: 15.5% — 10th highest
> Adults without health insurance: 10.1% — 14th highest
38. Oklahoma
> State spending on health in 2018: $1,676 per capita
> Health spending as share of all state spending in 2018: 26.2% — 19th lowest
> Total state health budget: $6.6 billion
> Population 65 and older: 16.1% — 12th lowest
> Population with a disability: 16.1% — 6th highest
> Adults without health insurance: 14.3% — 2nd highest
37. Arizona
> State spending on health in 2018: $1,676 per capita
> Health spending as share of all state spending in 2018: 29.7% — 18th highest
> Total state health budget: $12.2 billion
> Population 65 and older: 18.0% — 13th highest
> Population with a disability: 13.2% — 25th highest
> Adults without health insurance: 11.3% — 9th highest
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36. Colorado
> State spending on health in 2018: $1,680 per capita
> Health spending as share of all state spending in 2018: 25.8% — 17th lowest
> Total state health budget: $9.7 billion
> Population 65 and older: 14.7% — 5th lowest
> Population with a disability: 10.6% — 4th lowest
> Adults without health insurance: 8.0% — 25th lowest
35. Utah
> State spending on health in 2018: $1,712 per capita
> Health spending as share of all state spending in 2018: 25.1% — 15th lowest
> Total state health budget: $5.5 billion
> Population 65 and older: 11.4% — the lowest
> Population with a disability: 9.3% — the lowest
> Adults without health insurance: 9.7% — 18th highest
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34. Wyoming
> State spending on health in 2018: $1,817 per capita
> Health spending as share of all state spending in 2018: 16.9% — the lowest
> Total state health budget: $1.1 billion
> Population 65 and older: 17.1% — 24th highest
> Population with a disability: 13.4% — 24th highest
> Adults without health insurance: 12.3% — 6th highest
33. North Dakota
> State spending on health in 2018: $1,849 per capita
> Health spending as share of all state spending in 2018: 19.5% — 5th lowest
> Total state health budget: $1.4 billion
> Population 65 and older: 15.8% — 7th lowest
> Population with a disability: 11.4% — 7th lowest
> Adults without health insurance: 6.9% — 19th lowest
32. Alabama
> State spending on health in 2018: $1,859 per capita
> Health spending as share of all state spending in 2018: 26.9% — 21st lowest
> Total state health budget: $9.1 billion
> Population 65 and older: 17.4% — 20th highest
> Population with a disability: 15.9% — 8th highest
> Adults without health insurance: 9.7% — 17th highest
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31. Indiana
> State spending on health in 2018: $1,894 per capita
> Health spending as share of all state spending in 2018: 30.6% — 16th highest
> Total state health budget: $12.8 billion
> Population 65 and older: 16.1% — 13th lowest
> Population with a disability: 13.5% — 21st highest
> Adults without health insurance: 8.7% — 22nd highest
30. Michigan
> State spending on health in 2018: $1,900 per capita
> Health spending as share of all state spending in 2018: 24.9% — 13th lowest
> Total state health budget: $19.0 billion
> Population 65 and older: 17.7% — 14th highest
> Population with a disability: 14.3% — 14th highest
> Adults without health insurance: 5.8% — 10th lowest
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29. Virginia
> State spending on health in 2018: $1,944 per capita
> Health spending as share of all state spending in 2018: 29.4% — 20th highest
> Total state health budget: $16.6 billion
> Population 65 and older: 15.9% — 10th lowest
> Population with a disability: 12.2% — 18th lowest
> Adults without health insurance: 7.9% — 24th lowest
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28. South Carolina
> State spending on health in 2018: $1,966 per capita
> Health spending as share of all state spending in 2018: 28.9% — 24th highest
> Total state health budget: $10.1 billion
> Population 65 and older: 18.2% — 11th highest
> Population with a disability: 14.2% — 15th highest
> Adults without health insurance: 10.8% — 11th highest
27. Maine
> State spending on health in 2018: $1,986 per capita
> Health spending as share of all state spending in 2018: 28.9% — 25th highest
> Total state health budget: $2.7 billion
> Population 65 and older: 21.3% — the highest
> Population with a disability: 16.2% — 5th highest
> Adults without health insurance: 8.0% — 25th highest
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26. Maryland
> State spending on health in 2018: $2,028 per capita
> Health spending as share of all state spending in 2018: 26.5% — 20th lowest
> Total state health budget: $12.3 billion
> Population 65 and older: 15.9% — 9th lowest
> Population with a disability: 11.2% — 6th lowest
> Adults without health insurance: 6.0% — 12th lowest
25. Wisconsin
> State spending on health in 2018: $2,098 per capita
> Health spending as share of all state spending in 2018: 29.0% — 23rd highest
> Total state health budget: $12.2 billion
> Population 65 and older: 17.5% — 18th highest
> Population with a disability: 11.8% — 14th lowest
> Adults without health insurance: 5.7% — 8th lowest
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24. Washington
> State spending on health in 2018: $2,110 per capita
> Health spending as share of all state spending in 2018: 27.7% — 24th lowest
> Total state health budget: $16.1 billion
> Population 65 and older: 15.9% — 8th lowest
> Population with a disability: 12.7% — 22nd lowest
> Adults without health insurance: 6.6% — 17th lowest
23. New Jersey
> State spending on health in 2018: $2,142 per capita
> Health spending as share of all state spending in 2018: 24.1% — 12th lowest
> Total state health budget: $19.0 billion
> Population 65 and older: 16.6% — 21st lowest
> Population with a disability: 10.3% — 2nd lowest
> Adults without health insurance: 7.9% — 23rd lowest
22. Montana
> State spending on health in 2018: $2,192 per capita
> Health spending as share of all state spending in 2018: 30.0% — 17th highest
> Total state health budget: $2.3 billion
> Population 65 and older: 19.5% — 6th highest
> Population with a disability: 13.5% — 21st highest
> Adults without health insurance: 8.3% — 24th highest
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21. Missouri
> State spending on health in 2018: $2,217 per capita
> Health spending as share of all state spending in 2018: 38.9% — the highest
> Total state health budget: $13.6 billion
> Population 65 and older: 17.2% — 23rd highest
> Population with a disability: 14.7% — 12th highest
> Adults without health insurance: 10.0% — 15th highest
20. Kansas
> State spending on health in 2018: $2,257 per capita
> Health spending as share of all state spending in 2018: 33.6% — 7th highest
> Total state health budget: $6.6 billion
> Population 65 and older: 16.4% — 20th lowest
> Population with a disability: 13.5% — 21st highest
> Adults without health insurance: 9.2% — 19th highest
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19. West Virginia
> State spending on health in 2018: $2,345 per capita
> Health spending as share of all state spending in 2018: 27.4% — 23rd lowest
> Total state health budget: $4.2 billion
> Population 65 and older: 20.5% — 3rd highest
> Population with a disability: 19.8% — the highest
> Adults without health insurance: 6.7% — 18th lowest
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18. Pennsylvania
> State spending on health in 2018: $2,370 per capita
> Health spending as share of all state spending in 2018: 29.6% — 19th highest
> Total state health budget: $30.3 billion
> Population 65 and older: 18.7% — 8th highest
> Population with a disability: 14.0% — 16th highest
> Adults without health insurance: 5.8% — 9th lowest
17. Oregon
> State spending on health in 2018: $2,375 per capita
> Health spending as share of all state spending in 2018: 25.4% — 16th lowest
> Total state health budget: $10.0 billion
> Population 65 and older: 18.2% — 10th highest
> Population with a disability: 14.7% — 12th highest
> Adults without health insurance: 7.2% — 20th lowest
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16. Hawaii
> State spending on health in 2018: $2,401 per capita
> Health spending as share of all state spending in 2018: 24.9% — 14th lowest
> Total state health budget: $3.4 billion
> Population 65 and older: 19.0% — 7th highest
> Population with a disability: 11.9% — 16th lowest
> Adults without health insurance: 4.2% — 3rd lowest
15. Vermont
> State spending on health in 2018: $2,430 per capita
> Health spending as share of all state spending in 2018: 21.3% — 8th lowest
> Total state health budget: $1.5 billion
> Population 65 and older: 20.1% — 4th highest
> Population with a disability: 15.1% — 11th highest
> Adults without health insurance: 4.5% — 4th lowest
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14. Iowa
> State spending on health in 2018: $2,434 per capita
> Health spending as share of all state spending in 2018: 32.2% — 13th highest
> Total state health budget: $7.7 billion
> Population 65 and older: 17.5% — 17th highest
> Population with a disability: 11.8% — 14th lowest
> Adults without health insurance: 5.0% — 6th lowest
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13. Minnesota
> State spending on health in 2018: $2,436 per capita
> Health spending as share of all state spending in 2018: 27.7% — 25th lowest
> Total state health budget: $13.8 billion
> Population 65 and older: 16.3% — 18th lowest
> Population with a disability: 10.8% — 5th lowest
> Adults without health insurance: 4.9% — 5th lowest
12. Arkansas
> State spending on health in 2018: $2,522 per capita
> Health spending as share of all state spending in 2018: 33.8% — 5th highest
> Total state health budget: $7.6 billion
> Population 65 and older: 17.4% — 22nd highest
> Population with a disability: 17.5% — 3rd highest
> Adults without health insurance: 9.1% — 20th highest
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11. Ohio
> State spending on health in 2018: $2,527 per capita
> Health spending as share of all state spending in 2018: 33.2% — 9th highest
> Total state health budget: $29.5 billion
> Population 65 and older: 17.5% — 19th highest
> Population with a disability: 14.0% — 16th highest
> Adults without health insurance: 6.6% — 16th lowest
10. Mississippi
> State spending on health in 2018: $2,561 per capita
> Health spending as share of all state spending in 2018: 34.9% — 3rd highest
> Total state health budget: $7.6 billion
> Population 65 and older: 16.4% — 19th lowest
> Population with a disability: 16.8% — 4th highest
> Adults without health insurance: 13.0% — 5th highest
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9. Louisiana
> State spending on health in 2018: $2,621 per capita
> Health spending as share of all state spending in 2018: 34.7% — 4th highest
> Total state health budget: $12.2 billion
> Population 65 and older: 16.0% — 11th lowest
> Population with a disability: 15.9% — 8th highest
> Adults without health insurance: 8.9% — 21st highest
8. Rhode Island
> State spending on health in 2018: $2,890 per capita
> Health spending as share of all state spending in 2018: 32.3% — 12th highest
> Total state health budget: $3.1 billion
> Population 65 and older: 17.7% — 15th highest
> Population with a disability: 13.1% — 24th lowest
> Adults without health insurance: 4.1% — 2nd lowest
7. Kentucky
> State spending on health in 2018: $2,919 per capita
> Health spending as share of all state spending in 2018: 36.2% — 2nd highest
> Total state health budget: $13.0 billion
> Population 65 and older: 16.9% — 24th lowest
> Population with a disability: 17.9% — 2nd highest
> Adults without health insurance: 6.4% — 14th lowest
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6. Delaware
> State spending on health in 2018: $2,988 per capita
> Health spending as share of all state spending in 2018: 29.1% — 21st highest
> Total state health budget: $2.9 billion
> Population 65 and older: 19.5% — 5th highest
> Population with a disability: 13.8% — 18th highest
> Adults without health insurance: 6.6% — 15th lowest
5. Massachusetts
> State spending on health in 2018: $3,082 per capita
> Health spending as share of all state spending in 2018: 31.5% — 15th highest
> Total state health budget: $21.2 billion
> Population 65 and older: 17.0% — 25th highest
> Population with a disability: 11.5% — 10th lowest
> Adults without health insurance: 3.0% — the lowest
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4. California
> State spending on health in 2018: $3,109 per capita
> Health spending as share of all state spending in 2018: 32.7% — 11th highest
> Total state health budget: $122.4 billion
> Population 65 and older: 14.8% — 6th lowest
> Population with a disability: 10.6% — 4th lowest
> Adults without health insurance: 7.7% — 22nd lowest
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3. Alaska
> State spending on health in 2018: $3,150 per capita
> Health spending as share of all state spending in 2018: 19.2% — 4th lowest
> Total state health budget: $2.3 billion
> Population 65 and older: 12.4% — 2nd lowest
> Population with a disability: 11.7% — 12th lowest
> Adults without health insurance: 12.2% — 7th highest
2. New Mexico
> State spending on health in 2018: $3,405 per capita
> Health spending as share of all state spending in 2018: 33.3% — 8th highest
> Total state health budget: $7.1 billion
> Population 65 and older: 18.0% — 12th highest
> Population with a disability: 16.0% — 7th highest
> Adults without health insurance: 10.0% — 16th highest
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1. New York
> State spending on health in 2018: $3,698 per capita
> Health spending as share of all state spending in 2018: 33.7% — 6th highest
> Total state health budget: $71.9 billion
> Population 65 and older: 16.9% — 25th lowest
> Population with a disability: 11.6% — 11th lowest
> Adults without health insurance: 5.2% — 7th lowest
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