edited by
Sadie Harley, reviewed by Robert Egan

This article has been reviewed according to Science X's
editorial process
and policies.
Editors have highlighted
the following attributes while ensuring the content's credibility:

Nearly half of U.S. adults (47%) are worried they won't be able to afford necessary health care in the coming year, the highest level of concern recorded since West Health and Gallup began tracking in 2021. The share of Americans reporting that they or someone in their household were not able to pay for prescription medications in the past three months has reached a record high of 20%, or one in five Americans.

These trends are clear: millions of Americans are facing growing challenges to their health and financial well-being. A first-of-its-kind study from the newly launched West Health-Gallup Center for Healthcare in America reveals that these struggles differ significantly depending on where people live and help explain why health care is so central to our politics and our everyday lives.

The new release, "State of the States (SOS) Study: Insights on Healthcare in America", offers a comprehensive picture of health care across all 50 states and the District of Columbia, uncovering big differences in how Americans experience health care.

Unlike many existing rankings that focus on system-level metrics or health outcomes, the West Health-Gallup rankings fill a critical gap by capturing how Americans perceive cost, quality and access in their daily lives.

Based on the responses of nearly 20,000 Americans conducted across all 50 states and the District of Columbia, the study looks at three core pillars: cost, quality and access, assessing each state and ranking them based on how people responded to 27 detailed questions about their personal health care experiences.

Together, the results reveal a sobering portrait of health care in America—while some states outperform the national average, no state earns top marks.

The SOS Study finds that where Americans live has a significant impact on how they experience health care. Iowa, Massachusetts, the District of Columbia and Rhode Island rank highest in the nation for health care, with residents reporting better overall experiences, particularly in their ability to afford, access and receive quality care when and where they need it, according to the West Health-Gallup State of the States (SOS) 2025 study.

However, even in the top 10 states, sizable percentages of people are still struggling. In the top-ranked states, about 15% of residents say they've been unable to pay for prescriptions in the past three months, compared with 29% in the bottom 10 states.