The U.S. health care system faced new levels of scrutiny in the past year amid the COVID-19 pandemic. There were shortages of medical masks, ICU beds, as well as nurses. But even before the pandemic, some states were much better equipped to handle both everyday health needs — and the pandemic — than others.
There are many states in which residents are much more likely to lack health care insurance. In many of these states, there are also fewer medical professionals relative to the population, which can hinder access to care, as well as underfunded medical hospitals.
The health care system in Texas ranks as the worst in the country.
Texas ranks as the state with the worst health care system. This is in large part due to the high rate of residents of all ages lacking health insurance and the limited access to certain types of health care. The uninsured rate, at 18.4%, is double the national figure and higher than that of any other state.
The shares of people under 19 and under 6 years old lacking health insurance are also the highest in Texas. The state also has among the fewest mental health providers and primary care doctors per capita.
About 18.7% of adult residents in Texas report being in poor or fair health, the 13th highest share in the U.S. Additionally, Texas has a significantly higher rate of preventable hospitalizations at 4,793 per 100,000 people, the 13th highest in the U.S. This measure reflects how efficiently outpatient services are used as well as the overall quality of health care in a state.
To identify the states with the worst health care systems, 24/7 Wall St. constructed an index comprising six health measures for each state: the share of residents without health insurance, state spending on health care as well as on hospitals per capita, and the number of dentists, doctors, and mental health providers per 100,000 people. Each of these measures was weighted equally in the index. These are the 25 states with the worst health care system
| Rank | State | Uninsured rate | Adults in poor or fair health | Premium contribution, single coverage | State spending on health care per capita |
|---|---|---|---|---|---|
| 25 | Wyoming | 12.3% | 15.3% | $96.25 | $513 |
| 24 | Delaware | 6.6% | 16.3% | $127.92 | $480 |
| 23 | Montana | 8.3% | 14.1% | $93.50 | $167 |
| 22 | Missouri | 10.0% | 19.5% | $109.83 | $332 |
| 21 | Nebraska | 8.3% | 13.8% | $112.58 | $151 |
| 20 | Illinois | 7.4% | 15.9% | $115.17 | $97 |
| 19 | Kentucky | 6.4% | 21.8% | $121.08 | $98 |
| 18 | North Dakota | 6.9% | 13.6% | $98.50 | $188 |
| 17 | South Carolina | 10.8% | 17.8% | $111.58 | $247 |
| 16 | North Carolina | 11.3% | 18.0% | $115.92 | $164 |
| 15 | West Virginia | 6.7% | 23.6% | $113.08 | $160 |
| 14 | Oklahoma | 14.3% | 20.9% | $115.25 | $223 |
| 13 | South Dakota | 10.2% | 13.4% | $120.17 | $178 |
| 12 | Louisiana | 8.9% | 21.4% | $122.08 | $101 |
| 11 | Alabama | 9.7% | 21.4% | $132.75 | $117 |
| 10 | Arkansas | 9.1% | 23.3% | $104.42 | $58 |
| 9 | Florida | 13.2% | 19.5% | $120.17 | $225 |
| 8 | Idaho | 10.8% | 15.1% | $73.08 | $104 |
| 7 | Tennessee | 10.1% | 21.2% | $119.25 | $111 |
| 6 | Indiana | 8.7% | 18.2% | $121.67 | $90 |
| 5 | Nevada | 11.4% | 19.1% | $104.58 | $93 |
| 4 | Mississippi | 13.0% | 22.1% | $109.08 | $133 |
| 3 | Arizona | 11.3% | 18.6% | $126.92 | $81 |
| 2 | Georgia | 13.4% | 18.4% | $108.25 | $119 |
| 1 | Texas | 18.4% | 18.7% | $112.92 | $109 |
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