Health insurance premiums have climbed sharply in recent years, rising by 5% for individual plans and 6% for family plans in 2025 alone. While costs have risen nationwide, some states are far more expensive than others. In the costliest states, health insurance premiums can consume nearly 21% of the median household income, compared to less than 5% in the most affordable states.
To determine where health insurance is the biggest financial burden, WalletHub compared the average premiums for a silver health insurance plan offering a balance of moderate deductibles and relatively low premiums with median household income in all 50 states. Source: Wallet Hub
It seems to me when assessing the cost of health care, hence premiums, relative to household income, income matters at least as much as the cost of health care relative to income. Of course, Massachusetts will have a lower percentage because it has the highest household income and Mississippi will be higher even if the premiums were identical.
The reality is that health care costs are higher in the higher income states, yet the graphic above implies the opposite. For example:
Medium household income by state
District of Columbia: $109,707
• Massachusetts: $104,828
• New Jersey: $104,294
• Maryland: $102,905
• Hawaii: $100,745
• California: $100,149
• New Hampshire: $99,782
• Washington: $99,389
• Colorado: $97,113
• Utah: $96,658
• Alaska: $95,665
• Connecticut: $96,049
• Virginia: $92,090
• Minnesota: $87,117
• New York: $85,820
• Oregon: $85,220
• Rhode Island: $83,504
• Illinois: $83,211
• Delaware: $87,534
• Vermont: $82,730
• Nevada: $81,134
• Arizona: $81,486
• Idaho: $81,166
• Texas: $79,721
• Georgia: $79,991
• Pennsylvania: $77,545
• Florida: $77,735
• North Dakota: $77,871
• Maine: $76,442
• South Dakota: $76,881
• Nebraska: $76,376
• Iowa: $75,501
• Kansas: $75,514
• Wyoming: $75,532
• Wisconsin: $77,488
• Montana: $75,340
• Ohio: $72,212
• Michigan: $72,389
• Indiana: $71,959
• Tennessee: $71,997
• Missouri: $71,589
• North Carolina: $73,958
• South Carolina: $72,350
• Alabama: $66,659
• Kentucky: $64,526
• Oklahoma: $66,148
• New Mexico: $67,816
• Arkansas: $62,106
• Louisiana: $60,986
• West Virginia: $60,798
• Mississippi: $59,127
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