Healthcare is one of those bills that can make a state feel more or less affordable than it looks on paper. To compare states, WalletHub looked at the cost of five common healthcare items and measured that total against median monthly household income. The result is not a perfect picture of every family’s insurance situation, but it is a useful way to see where basic medical costs feel lighter, and where they can pinch harder. Let’s start off with the states where the smallest amount of income goes to healthcare.
Utah
Utah is the clear low-burden state in WalletHub’s 2026 ranking. That does not mean healthcare is cheap for everyone in Utah, especially for retirees, people with chronic conditions, or families facing high deductibles. But in this comparison, Utah benefits from a stronger income base and relatively manageable prices for the five items WalletHub measured. For everyday readers, the big lesson is simple: healthcare affordability is not just about the bill at the pharmacy. It is about how that bill lands against a household’s paycheck.
Virginia
Virginia comes in second-lowest. The state’s high-income suburbs around Washington, D.C., help pull the income side of the equation upward, even though healthcare itself is not free from the usual headaches. Seniors still have to think about Medicare premiums, supplemental coverage, dental work, and prescriptions. Younger families still have to read the fine print on deductibles. But as a statewide average, Virginia shows why income matter so much: a medical bill feels different when household earnings are stronger.
California
California may surprise readers because almost nothing about the state sounds cheap. But WalletHub’s measure is healthcare cost as a share of monthly income, not total cost of living. California’s 5.64% figure reflects the state’s high income, especially in job markets tied to technology, entertainment, healthcare, and professional services. That does not erase the state’s brutal housing costs or the unevenness between coastal and inland communities. It simply means that, on this healthcare-income metric, medical costs take a smaller slice of earnings than in most states.
New Jersey
New Jersey ranks fourth-lowest, with healthcare costs measured at 5.81% of monthly household income. The state is not known for bargain living, but high wages can soften the blow of certain recurring expenses. That is the same pattern seen in several lower-burden states: the medical basket may not be especially cheap, but household income gives residents more room to absorb it. For older readers thinking about retirement, this is a reminder to compare healthcare, housing, taxes, and transportation together.
Nevada
Nevada rounds out the five lowest-burden states. This does not mean every Nevada resident has easy access to care; rural counties can face distance and provider-access issues, and Las Vegas-area growth can strain services. Still, WalletHub’s income-adjusted ranking puts Nevada in a favorable spot for basic healthcare affordability. For people comparing states, Nevada is a good example of why the headline price of a doctor visit is only half the story. The other half is whether local incomes can keep up.
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Colorado
Colorado lands just outside the top five. The state has a strong labor market in areas such as technology, aerospace, healthcare, education, and outdoor-recreation-related work, which helps the income side of the formula. But affordability can look very different in Denver, mountain towns, and rural parts of the state. A retired couple in a pricey county may not feel the same cushion as a working household with employer coverage. The statewide number is useful, but local reality still matters.
Florida
Florida ties Colorado at 6.05%, an interesting result for a state with such a large older population. The ranking does not mean Florida healthcare is painless for retirees; Medicare decisions, dental care, specialists, and prescriptions can still be expensive. But the specific WalletHub basket, compared with monthly income, puts Florida among the lower-burden states.
Rhode Island
Rhode Island, as a small state, it can be easy to compare doctors, pharmacies, and nearby hospital systems across a shorter distance than in sprawling rural states. But small does not automatically mean cheap. Rhode Island’s placement is mainly about the relationship between measured healthcare costs and income. For households on fixed incomes, the ranking is encouraging, but it should still be paired with a close look at Medicare Advantage networks, specialists, and out-of-pocket caps.
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Minnesota
Minnesota sits at 6.09%, helped by a relatively strong income base and a deep healthcare infrastructure. The state is home to major medical systems and has a long reputation for healthcare access and quality, though that does not mean every bill is easy to swallow. Rural Minnesotans may still travel for specialists, and older adults still need to budget for premiums, dental work, hearing care, and prescriptions.
South Carolina
South Carolina completes the lowest-burden top 10 at 6.13%. That may surprise readers who associate the Southeast with lower incomes and higher chronic-disease burdens. South Carolina’s position means those measured costs take a smaller share of income than in many other states. It does not erase access issues in rural areas or the financial pressure of serious illness. It simply gives budget-conscious households one more data point when comparing where money may stretch.
Alaska
Alaska ranks as the highest-burden state in WalletHub’s 2026 analysis, with the healthcare basket equal to 10.08% of monthly household income. This is not mainly an income story; Alaska has relatively high earnings compared with many states. The bigger issue is price. WalletHub notes that Alaska has especially expensive medical services and commodities, including the highest doctor-visit price among states in its dataset.
Oregon
Oregon ranks second-highest, with measured healthcare costs taking 9.32% of monthly household income. WalletHub points out that Oregon’s burden is driven less by low income and more by prices for certain services. The state ranked among the costlier places in the dataset for doctor and optometrist visits, even though it was cheaper for Lipitor.
Maine
Maine comes in third-highest at 9.30%. Here, the burden is a combination of prices and income. WalletHub notes that Maine has a lower household income than many states and relatively high prices for several measured healthcare services, including doctor, optometrist, and dentist visits. Maine is also one of the oldest states demographically, which makes healthcare affordability especially relevant for retirees and near-retirees.
Mississippi
Mississippi ranks fourth-highest. It’s problem is not necessarily that every healthcare price is the highest in the country. The strain comes from lower household incomes, which make ordinary medical costs harder to absorb. That matters for families choosing between a copay, a prescription refill, groceries, and the utility bill. For older residents, the pressure can be even sharper when a fixed income meets dental work, hearing care, or prescriptions that are not fully covered.
West Virginia
West Virginia ranks fifth-highest at 9.14%. The state often faces the double problem of lower incomes and greater healthcare needs, particularly in communities dealing with chronic conditions and limited provider access. Rural geography can add another hidden cost: time, gas, and travel for appointments. Affordability is not just the bill itself. It is also the distance to care, the deductible, the pharmacy counter, and the income left after everything else is paid.
New Mexico
New Mexico ranks sixth-highest, with healthcare costs taking up 9.07% of monthly household income. The problem is not just what care costs, but how far household income has to stretch. In rural parts of the state, getting care can also mean long drives, missed work, and fewer nearby options. So while New Mexico may look affordable on housing, medical costs can quickly change the math for retirees or anyone thinking about relocating.
North Carolina
North Carolina ranks seventh-highest at 8.78%. The state has booming metro areas, respected medical systems, and fast-growing retirement communities, but statewide averages can hide a lot of unevenness. Meanwhile, incomes vary widely across the state. WalletHub’s ranking suggests that, when common healthcare costs are compared with monthly income, North Carolina residents still face a higher burden than most states.
Montana
Montana ranks eighth-highest, at 8.62% of monthly household income. Like Alaska and Maine, Montana reminds readers that geography can be expensive. Big distances, rural hospitals, fewer providers, and travel for specialty care can all shape what healthcare really costs. For retirees drawn to wide-open spaces, this is the practical question: how close is the care you expect to use regularly? A beautiful view is wonderful, but so is a reachable doctor and a pharmacy that fits your budget.
South Dakota
South Dakota ranks ninth-highest at 8.60%. The state can be attractive for taxes, space, and a lower-key pace of life, but healthcare affordability still deserves a hard look. Rural access can vary, and the cost of getting to care may not show up in a simple doctor-visit price. For older adults especially, it is worth comparing Medicare plan availability, prescription coverage, dental options, and local provider networks before assuming a low-cost state is low-cost in every category.
Louisiana
Louisiana rounds out the 10 highest-burden states at 8.13%. The state’s challenge is familiar across many lower-income areas: even ordinary healthcare expenses can feel heavy when household earnings are stretched by insurance, groceries, housing, and transportation. Louisiana also has communities where access and chronic-health needs complicate the picture. For families and retirees, the safest approach is to budget for care before the bill arrives.
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