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Bottom 11 states with lowest annual health spending per person

Study examines per capita spending trends up to 2019.

It’s no surprise to say health care spending is rising around the United States.

But costs and spending aren’t the same everywhere. A study this year found the 50 states have a range of per capita spending and rates of increase, and the state with the highest per person spending had an amount double that of the state with the lowest.

“Varied Health Spending Growth Across US States Was Associated With Incomes, Price Levels, and Medicaid Expansion, 2000-19,” was published in August in Health Affairs. The study updated the 2014 estimates of health spending per person across the 50 states and Washington, D.C., up to the year before the COVID-19 pandemic.

Here are the 11 states where annual per person spending is lowest, in 2020 U.S. dollars, and at less than $9,000. The research included the states’ annualized rate of change per person from 2013 to 2019.

The slides show two other figures: Standardized annual spending per person and standardized annualized rate of change per person 2013-2019. Those figures are adjusted to reflect age and sex profile, economywide prices, mean income, population density, smoking rates, and physical activity rates.

The figures don’t necessarily mean people in those states are getting needed, adequate health care at rock-bottom prices. It may be that people who need health care don’t seek it out because they can’t afford it.

The researchers noted “those living in states with lower mean income had lower spending despite having a generally higher need for health care in poor regions because of systematically worse health.”

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Jay W. Lee, MD, MPH, FAAFP headshot | © American Association of Family Practitioners