New ranking puts California ahead of many large states but behind top health care performers
Sacramento, California – California’s health care system does not land in the national top 10, but it comes close enough to show how far the state has moved, and where the work is still unfinished.
According to Sacramento local news outlet News Sickle Arrow, California ranks 11th overall, earning a final score of 71.6 out of 100 in an analysis that compares outcomes, costs and access across all 50 states and Washington, D.C.
In MoneyGeek’s 2026 Best States for Health Care report, California ranks 11th overall, earning a final score of 71.6 out of 100 in an analysis that compares outcomes, costs and access across all 50 states and Washington, D.C.
That position tells two stories at once. California is not Hawaii, which leads the country with a score of 87.6, and it still trails states such as Massachusetts, Washington and Colorado.
But the MoneyGeek’s 2026 Best States for Health Care report also shows that it sits well above much of the country, especially many large states where coverage gaps, cost barriers and weaker health outcomes continue to drag rankings down.
For a state as large, expensive and diverse as California, 11th place is not a small result. It is a sign of real strength, with pressure points that remain hard to ignore.
The strongest part of California’s showing is health outcomes. The report shows an outcomes score of 90.5, far higher than its access score of 50.8 and ahead of its cost score of 73.7. The clearest number behind that strength is mortality.
California recorded the fourth-lowest all-cause mortality rate in the country, at 644.6 deaths per 100,000 residents, behind only Hawaii, New York and New Jersey.
That is the bright side of the report. It suggests that California’s long-term focus on coverage, prevention, public health and chronic disease management has helped produce stronger life-and-death results than many peer states.
The state’s health system is far from simple, but on the most important measure, whether people are living longer and avoiding worse outcomes, California performs like a national leader.
The picture becomes more mixed when access enters the frame. California’s access score of 50.8 is not a collapse, but it is clearly not elite. That middling result reflects a familiar problem in the state: health coverage has expanded widely, yet getting care can still depend heavily on where a person lives, how many providers are nearby and whether local systems are stretched.
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Rural communities, inland regions and underserved neighborhoods do not always experience California’s health care system the same way wealthier coastal areas do.
Costs remain another pressure point. California’s 73.7 cost score is solid, especially compared with states facing severe premium or spending problems, but affordability is still a daily concern in a high-cost state.
The national data shows how wide the cost gap can be, with Maryland posting one of the lowest ACA benchmark premiums and states such as Vermont and New York sitting among the highest. California is not at the bottom on cost, but it is also not free from the broader affordability crisis shaping American health care.
The contrast with other large states is sharp. Texas ranks 46th with a final score of 35.6 and received a zero on MoneyGeek’s access pillar. It also had the highest uninsured rate in the report, at 16.3%.
Florida ranked 37th with a score of 47.5 and was among the states with the highest uninsured rates, at 10.5%.
New York offers a different lesson: it posted excellent outcomes, but its overall rank fell to 23rd because of high costs, including per capita spending of $14,007 and a low-cost score of 15.4.
California’s ranking also reflects years of policy choices. The state moved early under the Affordable Care Act, expanded Medi-Cal, built Covered California into one of the country’s major health insurance marketplaces and continued layering reforms after the first wave of ACA implementation.
A California Health Care Foundation analysis found that close to 94% of Californians had health insurance in 2022, a major improvement from about 15% uninsured in 2013.
More recent reforms are aimed at making coverage mean more than an insurance card. Through CalAIM, California is trying to reshape Medi-Cal around whole-person care, especially for people with complex needs.
The state’s Enhanced Care Management benefit connects eligible Medi-Cal members with a lead care manager, while Community Supports are designed to address needs that affect health outside the doctor’s office, including housing-related and other social supports.
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That approach helps explain why California looks more like a strong West Coast or Northeast performer than a struggling large state. Its system has deep investments, broad coverage and a clear focus on outcomes.
But the same report shows why the next stage may be harder. The state must turn strong coverage into easier access, keep costs from overwhelming families and close gaps between regions and communities.
So California’s 11th-place ranking is not a victory lap. It is a checkpoint. The state has built a health care model that delivers strong outcomes and stands far ahead of many peers.
Now the challenge is whether it can make that strength feel real for more Californians, not only in statewide data, but in the appointment a patient can actually get, the bill a family can actually pay and the care that reaches people before a crisis begins.
