Access to care is increasingly becoming a problem for all Americans, in the wake of the Trump budget law that cuts $1 trillion from Medicaid. Health care costs continue to rise appreciably, and the latest Gallup poll shows that almost half of all Americans worry about whether they can pay for needed care. This is the highest degree of concern about health care affordability in the last four years, when Gallup began tracking this data.
In addition, Gallup reports that 30 percent of those polled said that they or a household member skipped medical care in the last year because of the cost. And, more Americans than ever, 20 percent, say that either they or someone in their home could not afford prescription drugs in the last three months. The healthcare cost, quality and access experiences of Americans differ across the 50 states.
That said, survey participants in every state gave health care costs a D or D+ ranking. And, the best overall score for a state was a C+ ! Massachusetts got the best state score on quality with a B- . Every other state scored somewhere in the C range on quality. On health care access, every state scored in the C range except New Mexico, which scored a D+ .
The top states, Iowa, Rhode Island, Virginia and Massachusetts, as well as the District of Columbia, scored marginally better on cost, quality and access, but still had thousands and sometimes millions of residents who struggled to pay for care. Alaska, Arkansas and Texas scored at the bottom of the pack. People living in the states that ranked higher are more likely to get care and prescription drugs than people living in the lower scoring states. For example, 25 percent of people in the “top-ranking” states did not get care in the last year because they did not have the money to pay for it and 40 percent of people in the lower-ranking states went without care because they did not have the money to pay for it.
You can see all the rankings here.
Here’s more from Just Care:
- 2025: Planning for health care costs in retirement
- Debt among older Americans increasing in good part because of health care costs
- Poll: Republican candidates could be hurt in mid-terms if they don’t extend ACA subsidies
- The deadly consequences of out-of-pocket drug costs
- 1.6 million Americans with Medicaid lost their coverage between January and July 2025
