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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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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