Vermont Business Magazine Vermont has particularly high rates of insurance coverage, a national study has found. It ranks second nationwide for the overall coverage rate, at 95 percent, the children’s coverage rate, at 97.8 percent, and the coverage rate for people living in low-income households, at 92.8 percent. Likewise, Merritt Hawkins ranked Vermont as the third-best US state when it comes to physician access. In a nationwide study, SmartAsset has uncovered the best states for healthcare access, and Vermont ties with Michigan for the number four spot overall. Texas was last and was one of only two states to cover less than 90 percent of children (Alaska, see table below).
Medical science has made enormous strides over the past century. Antibiotics, vaccinations and other treatments have all but eliminated many illnesses that once claimed thousands of lives each year. Likewise, advancements in surgical techniques and technologies have pushed the survival rates on many difficult procedures, including open-heart surgery, to over 95 percent.
Yet as a whole, the healthcare system in the United States remains far from perfect. For example, in all but two states, more than 10% of low-income people do not have health insurance (as of 2014).
Data & Methodology
To find the best states for healthcare access, SmartAsset collected and analyzed data on healthcare access, affordability and quality across all 50 states. In particular, we looked at the following six metrics:
- Total insurance rate. This is the percentage of total population with health insurance.
- Children’s insurance rate. The percentage of children (under the age of 18) with health insurance.
- Low-income insurance rate. The percentage of people whose income is less than 139% of the federal poverty line with health insurance.
- Average monthly insurance premium. Includes individual market policies only.
- Average annual insurance costs as a percentage of median individual income.
- Physician access index. A measure developed by Merritt Hawkins based on 33 different metrics of physician access, such as the number of physicians per capita and the number of retail clinics per capita.
- Prevention and treatment rank. A measure of healthcare quality developed by the Commonwealth Fund, based on metrics such as the 30-day mortality at hospitals and the percentage of children who have received all recommended vaccines.
SmartAsset ranked all 50 states on those six metrics. SmartAsset then averaged those rankings, giving double weight to the physician access index and the prevention and treatment rank, and single weight to all other metrics.
Lastly, SmartAsset calculated a score on a 100-point scale according to those average rankings. States with better average rankings received higher scores. The top overall state scored a 100.
Data on insurance rates comes from the U.S. Census Bureau’s 2014 American Communities Survey. Data on the average monthly insurance premium comes from the Kaiser Family Foundation. Data on the median annual income comes from the Bureau of Labor Statistics.
- Medicaid expansion looms large. Nineteen states have yet to adopt the Medicaid expansion provision that was part of the Affordable Care Act. Just one of those states (Wisconsin) ranks in the top ten for healthcare access, while six rank in the bottom ten. These states tend to have lower insurance rates for children and people in low-income households.
- Midwest, New England states have best healthcare access. Three Midwestern states (Minnesota, Michigan and Wisconsin) and three states in New England (Massachusetts, Vermont and Rhode Island) rank in the 10.
- Texas comes in last. There’s only one state in which more than 30% of people in low-income households are uninsured, and that’s Texas. The state also ranks in the bottom five for physician access and the quality of treatment.
The top state for healthcare access, Maryland rated well on every single one of the metrics we considered. Its overall insurance rate and children’s insurance rate both rank among the top ten states, at 92.1% and 96.8% respectively. It also ranks in the top five for physician access.
What truly separates Maryland from other states when it come to overall healthcare access, however, is cost. While Maryland in general is fairly expensive, the state has managed to keep the cost of healthcare and the price of insurance premiums relatively low. According to the Kaiser Family Foundation, the average monthly cost of premiums is $180.40. On an annual basis, that’s equal to just 5.3% of median individual income, the lowest percentage of any state.
One reason for these low costs may be Maryland’s “all-payer” system. In such a system, all insurers (government and private) pay the same rates for services at a given hospital. It is the only state with such a system, though several European countries use similar systems.
Minnesota is home to some of the best health care facilities in the world, most notably the Mayo Clinic. According to the Commonwealth Fund, the state ranks as the eighth best state for prevention and treatment. It has the lowest number of premature deaths caused by potentially treatable conditions or complications, with just 56 per 100,000 residents.
It isn’t just the quality of care that makes Minnesota a great place for healthcare access. It also has some of the highest insurance rates in the country. As of 2014, 94.1% of Minnesotans had health insurance, fourth-highest of any state.
In 2006, Massachusetts passed a first-of-its-kind healthcare law that aimed to provide health insurance to every man, woman and child in the state. That plan, which eventually became a model for the Affordable Care Act, hasn’t yet achieved its lofty goal but it has come close. Massachusetts ranks first in the country for the overall insurance rate, at 96.7%, as well as the children’s insurance rate (98.5%) and the insurance rate for people living in low-income households (94.4%).
The one area in which Massachusetts does not rate well is the cost of insurance. According to the Kaiser Family Foundation, the average price of an individual policy in the Bay State is $456.39. Even after controlling for the state’s relatively high level of income, that ranks among the highest four states in the U.S., adding to the high cost of living in cities like Boston.
Michigan ranks no lower than 16th in the U.S. on any of the seven metrics SmartAsset analyzed. It rates especially well for the price of insurance premiums. The average cost of monthly individual insurance premiums in the Great Lakes State is $203.84, ninth lowest in the U.S. On an annual basis, that’s equal to 7% of the median income in Michigan. That makes it the sixth-most affordable state for health insurance when controlling for income.
Though Vermont recently abandoned efforts to establish a first-in-the-nation single-payer healthcare system, it still ranks among the top states when it comes to access. It has particularly high rates of insurance coverage. 95% of the total population of Vermont is insured and 97.8% of children in Vermont are insured. Both of those rank second behind Massachusetts.
VERY TOP PHOTO: Courtesy of Gifford Medical Center, Randolph.