The U.S. House of Representatives approved a new health care package Wednesday aimed at lowering costs for Americans. Notably, the legislation does not address the expiration of enhanced subsidies under the Affordable Care Act (ACA). Those tax credits are set to expire at the end of December, resulting in higher premiums for millions of people beginning in 2026.
With that financial strain looming, WalletHub has released new rankings showing where Americans already spend the most (and least) on health care.
Overall, California ranks among the states with the lowest health care spending as a percentage of income. There are several contributing factors, including the state’s extensive managed care networks, significant government purchasing power, and a stronger emphasis on prevention and primary care.
“In order to determine the cities that spend the most and least on health care, WalletHub analyzed the prices of five components,” according to the website. Those factors include the costs of doctor, dentist, and optometrist visits, as well as the prices of ibuprofen and insulin glargine, across the nation’s 100 largest cities.
These 10 cities spend the most on health care, according to WalletHub:
1. Detroit, MI (13.17%)
2. Cleveland, OH (11.35%)
3. Newark, NJ (11.28%)
4. Toledo, OH (11.03%)
5. Birmingham, AL (9.97%)
6. Milwaukee, WI (9.58%)
7. Winston-Salem, NC (9.44%)
8. New Orleans, LA (9.28%)
9. Spokane, WA (9.16%)
10. Baton Rouge, LA (9.01%)
These 10 cities spend the least:
91. San Francisco, CA (4.64%)
92. Henderson, NV (4.62%)
93. San Jose, CA (4.60%)
94. Santa Clarita, CA (4.15%)
95. Chandler, AZ (4.14%)
96. Huntington Beach, CA (4.13%)
97. Scottsdale, AZ (4.00%)
98. Irvine, CA (3.82%)
99. Fremont, CA (3.67%)
100. Gilbert, AZ (3.54%)
See full list and methodology here.
Lists and data were compiled by WalletHub and do not reflect statistics on all cities.