15 State Governments Spending the Most on Health Care

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Male patient angry at expensive healthcare bill
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Editor's Note: This story originally appeared on Self.

The COVID-19 pandemic has put unprecedented strain on the U.S. health system over the last two years. With hospitals and providers facing heavy workloads, a fractured supply chain, and labor shortages, the system is continuing to struggle as the omicron variant of the coronavirus that causes COVID-19 brings the newest, largest wave of cases yet.

These challenges are pushing U.S. health spending to new heights. A recent study from Health Affairs reported that total health spending in the U.S. increased by 9.7% in 2020 to $4.1 trillion, even as GDP declined by 2.2%.

One of the biggest factors in that increase was a significant infusion of federal funding for health through COVID-19 relief legislation like the $2.2 trillion CARES Act and the $900 billion Coronavirus Response and Relief Supplemental Appropriations Act. These federal dollars provided support to health providers, helped strengthen public health infrastructure to manage the spread of the coronavirus, and sped the development and distribution of vaccines.

But while the federal government has spent heavily to navigate the current crisis, it is less clear how COVID-19 might affect overall health spending in the long term. Even before COVID-19, state and local governments have been spending an increasingly large share of their budgets on health. Ongoing challenges from the pandemic and efforts to strengthen the health system in the future could further accelerate that growth.

To determine the states spending the most on health care, researchers at Self calculated state and local health care spending per resident using the most recent data available. The data used in this analysis is from the U.S. Census Bureau’s Annual Survey of State and Local Government Finances.

Here are the states spending the most on their residents’ health care.

15. Virginia

Arlington, Virginia
Sean Pavone / Shutterstock.com
  • State & local health care spending per capita: $988
  • State & local health care spending share of total: 10.5%
  • Total state & local health care spending: $8,429,368,000
  • Population: 8,535,519

14. Michigan

Detroit, Michigan
Stephanie Kenner / Shutterstock.com
  • State & local health care spending per capita: $1,013
  • State & local health care spending share of total: 10.8%
  • Total state & local health care spending: $10,119,784,000
  • Population: 9,986,857

13. Utah

Salt Lake City, Utah
f11photo / Shutterstock.com
  • State & local health care spending per capita: $1,123
  • State & local health care spending share of total: 12.0%
  • Total state & local health care spending: $3,600,612,000
  • Population: 3,205,958

12. Oregon

Bridge over Willamette River, Oregon
JPL Designs / Shutterstock.com
  • State & local health care spending per capita: $1,142
  • State & local health care spending share of total: 9.5%
  • Total state & local health care spending: $4,815,765,000
  • Population: 4,217,737

11. Missouri

St. Joseph, Missouri
APN Photography / Shutterstock.com
  • State & local health care spending per capita: $1,163
  • State & local health care spending share of total: 14.2%
  • Total state & local health care spending: $7,137,657,000
  • Population: 6,137,428

10. New York

Albany, New York
Sean Pavone / Shutterstock.com
  • State & local health care spending per capita: $1,315
  • State & local health care spending share of total: 8.4%
  • Total state & local health care spending: $25,588,914,000
  • Population: 19,453,561

9. Alabama

Montgomery Alabama
Kevin Ruck / Shutterstock.com
  • State & local health care spending per capita: $1,474
  • State & local health care spending share of total: 16.8%
  • Total state & local health care spending: $7,228,538,000
  • Population: 4,903,185

8. Iowa

Dubuque, Iowa
Joseph Sohm / Shutterstock.com
  • State & local health care spending per capita: $1,499
  • State & local health care spending share of total: 14.3%
  • Total state & local health care spending: $4,729,036,000
  • Population: 3,155,070

7. Washington

Seattle
cdrin / Shutterstock.com
  • State & local health care spending per capita: $1,512
  • State & local health care spending share of total: 14.0%
  • Total state & local health care spending: $11,513,156,000
  • Population: 7,614,893

6. California

Escondido, California
Hernando Sorzano / Shutterstock.com
  • State & local health care spending per capita: $1,533
  • State & local health care spending share of total: 11.7%
  • Total state & local health care spending: $60,569,031,000
  • Population: 39,512,223

5. North Carolina

Winston-Salem, North Carolina
Sean Pavone / Shutterstock.com
  • State & local health care spending per capita: $1,536
  • State & local health care spending share of total: 17.9%
  • Total state & local health care spending: $16,105,067,000
  • Population: 10,488,084

4. Mississippi

Jackson, Mississippi
Sean Pavone / Shutterstock.com
  • State & local health care spending per capita: $1,547
  • State & local health care spending share of total: 17.3%
  • Total state & local health care spending: $4,605,287,000
  • Population: 2,976,149

3. Kansas

Overland Park Kansas
Jacob Boomsma / Shutterstock.com
  • State & local health care spending per capita: $1,558
  • State & local health care spending share of total: 16.1%
  • Total state & local health care spending: $4,538,829,000
  • Population: 2,913,314

2. South Carolina

Spartanburg, South Carolina
Kevin Ruck / Shutterstock.com
  • State & local health care spending per capita: $1,730
  • State & local health care spending share of total: 19.3%
  • Total state & local health care spending: $8,905,798,000
  • Population: 5,148,714

1. Wyoming

Sheridan, Wyoming
Sandra Foyt / Shutterstock.com
  • State & local health care spending per capita: $2,978
  • State & local health care spending share of total: 19.7%
  • Total state & local health care spending: $1,723,417,000
  • Population: 578,759

Methodology

Man analyzing data on a laptop
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The data used in this analysis is from the U.S. Census Bureau’s Annual Survey of State and Local Government Finances and the U.S. Census Bureau’s American Community Survey 1-Year Estimates.

To determine the states spending the most on health care, researchers calculated total state and local health care spending per person using the most recent data available.

The two categories used to define health care spending were “hospitals” and “health,” which were summed together. A full list of definitions from the survey can be found here.

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