Americans spend the most on health insurance in West Virginia and the least in Maryland, according to a WalletHub analysis published July 9.
The personal finance company compared the average premiums for a silver health insurance plan with each state’s median household income using June 2026 data from the U.S. Census Bureau and KFF. It calculated insurance costs as a percentage of median monthly household income to rank all 50 states.
The 10 states where people spend the most on health insurance, based on insurance costs as a percentage of median monthly household income:
1. West Virginia — 20.86%
2. Vermont — 19.05%
3. Wyoming — 17.16%
4. Arkansas — 14.87%
5. Mississippi — 14.05%
6. Alaska — 13.18%
7. Louisiana — 12.58%
8. Tennessee — 12.19%
9. Alabama — 11.85%
10. Montana — 11.27%
The 10 states where people spend the least on health insurance:
1. Maryland — 4.66%
2. New Hampshire — 4.77%
3. Massachusetts — 5.49%
4. Virginia — 5.86%
5. Minnesota — 5.89%
6. New Jersey — 6.23%
7. California — 6.32%
8. Hawaii — 6.37%
9. Rhode Island — 6.67%
10. Colorado — 6.72%
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