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South Dakota Has Highest Health Care Costs

Be careful not to slip on the ice when the cold and snow come back. If you get hurt shoveling, you’ll pay your South Dakota doctors and nurses more to patch you up than you will in any other state of the Union. Forbes Advisor reads data from the Kaiser Family Foundation and finds South Dakota has the most expensive healthcare in America:

  • The families of 12% of children in South Dakota struggled to pay for their child’s medical bills between 2019 and 2020, making the state tied for fourth highest in the nation for this metric. Only Wyoming, Florida and Texas were higher. Nebraska, Kansas and Indiana were tied with South Dakota.
  • The Mount Rushmore State also ranked ninth highest for health care costs per person in the state, with South Dakota health care costs averaging $11,736 per year for services, such as hospital care, doctor’s visits, nursing home care and prescription medications.
  • South Dakota also had the third highest increase in overall health care spending per person over a five-year period (24.38%). Only New York and Hawaii saw bigger jumps.
  • South Dakota had the sixth highest annual health insurance premium for those with individual plans in the Affordable Care Act marketplace ($7,156) and the third highest annual health insurance deductible for employer-provided insurance among those with single coverage ($2,428) [Les Masterson, "Most and Least Expensive States for Health Care, Ranked," Forbes Advisor, 2022.11.08].

Evidently it's a good thing we just passed Medicaid expansion so we can help several thousand more South Dakotans pay for the most expensive health care in America.

But if Medicaid expansion doesn't help you, the cheapest health care in the region is in Minnesota, which ranks 38th for health care costs in this analysis. Wyoming ranks 5th, Nebraska 6th, North Dakota 24th, Montana 30th, and Iowa 36th. So if you do slip on the ice, slip east for a more affordable doctor visit!


  1. leslie 2022-11-22

    The strange separate billionaire medical kingdoms “monopolizing” the east edge near Minneapolis and the west edge of the state’s “island in the prairie” must have something to do with those highest costs in this red state “paradise”?

    Sen. Diedrich, who is somewhat liberal, would know.

  2. P 2022-11-22

    Your missing the boat a bit to not have some comparative benefits, especially given the Grabbenhoff (and associates) “get outta here” payout. In other words how do they compare with other medical management payouts vs employee benefits? Non-profit?yeah right!

    More to follow?

  3. larry kurtz 2022-11-22

    Montana held first place in 2021 but South Dakota is again the most lucrative state to practice medicine thanks to its medical industry triopoly. Nurses’ salaries still surf the bottom and the state is 22nd in “medical environment” so why isn’t there a regulatory body like the Public Utilities Commission to regulate medical care costs? Because the state is a corporatist tax haven for an exclusive set of Republicans while over $4 trillion languishes in South Dakota banks and trusts.

  4. leslie 2022-11-22

    The Standard observed a couple days ago:

    “South Dakotans who liked [Smith] and agreed with him on issues. But they just couldn’t bring themselves to vote for a Democrat.”

    Until high-profile people like Diedrich and Helene Duhamel, liberals in experience, courageously drop their Trumpist-like loyalty “oaths”, Red South Dakota will continue to show national unintended, or intended prominence, like bearing the highest-poverty County in the nation. They enable the Tricky Dicks, the B-actor Presidents Reagan and Trump, and the Bushes and their war-lord Cheneys of the right.

    Leading to the Putins and the Bolsonaros and the DeSantises, Abbots, Noems etc, and the divisive pathological narcissism of Trumpism and Saudi Royalty. And the seamy Rupert Murdochs of the world.

    Disgraceful. Its all about the money.

  5. flopster 2022-11-22

    Yep and another elderly care center closing (in Elk Point).
    Such a stellar Gov. (Not)
    She cares nothing for our state, elderly and the Medicaid needful.
    She is shameful and just as culpable are those who voted her back in.

  6. P. Aitch 2022-11-22

    Small government has negative consequences.
    Your costs are outrageous because your majority considers buying as a group to be anti-free market.
    Now y’all just pay out the orifice (which never gets examined) because colonoscopies are too costly.
    If it wasn’t for Obamacare’s preventative procedure pricing, Lederman would’ve gone into the mortician business instead of the weed business.

  7. LCJ 2022-11-22

    Recently, Prairie Lakes Hospital paid $3 million for naming rights to the new ice arena in Watertown. Just saying.

  8. Jenny 2022-11-22

    Way to go SD Pubs! “Expensive healthcare costs are a part of the traditional American Way of life. Freeedom isn’t free” Kristi Noem would say.
    “Keeping healthcare costs high helps keep our number one economy going in SD.”

    Courtesy of your Pierre Pubs and Gov Noem

  9. e platypus onion 2022-11-22

    Noem and Fury will likely call Forbes a liberal bunch of liars and not provide any proof. That should cover their butts.

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