Health insurance premiums are taking a significant bite out of household incomes for many residents in the Northeast, while others across the U.S. are feeling far less strain, according to a new national study.
WalletHub released its 2025 ranking of the states where people spend the most and least on health insurance on Thursday, July 10. The list compares the cost of silver-tier health insurance plans—commonly chosen for their balance of cost and coverage—against median household incomes in all 50 states.
In 2024, premiums rose again: 6% for individual plans and 7% for family plans, continuing a multi-year trend of steep increases.
“Inflation has driven up health insurance premiums significantly in recent years, making it harder and harder for Americans to afford proper health care,” said WalletHub analyst Chip Lupo. “Being without insurance is even more dangerous, though, as medical debt is one of the most common reasons people file for bankruptcy.”
He noted that some states are hit harder than others, with residents in certain areas spending up to 20% of their income on premiums, while others spend as little as 4%.
In the Northeast, New York ranked fifth-highest nationally, with residents spending 10.87% of their household income on monthly premiums. Connecticut ranked 19th, with premiums consuming 8.45% of income.
Massachusetts residents fare better, ranking 46th, with only 4.96% of income going toward premiums. Virginia and Maryland did even better, coming in at 48th and 49th, with residents spending just 4.85% and 4.27% of income, respectively.
Other regional states landed in the middle of the list. Pennsylvania ranked 33rd (6.96%), and New Jersey placed 43rd (5.72%).
The study reflects growing concerns about the affordability of health care, especially amid policy uncertainty. Paul Shafer, co-director of the Medicaid Policy Lab at Boston University, warned that potential cuts to Medicaid and insurance subsidies could worsen the situation.
“There is a lot of uncertainty right now about whether the Trump administration and Congress will cut funding for Medicaid and premium help in the marketplace,” Shafer said. “If those cuts go through, we could see about 11 million more Americans left uninsured.”
He advised anyone enrolled in Medicaid, HealthCare.gov, or state insurance marketplaces to closely monitor future developments, as they could have a major impact on the affordability of health coverage.
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