MITCHELL, SD (Mitchell Now) — Nearly half of South Dakotans say they are concerned about affording necessary healthcare in the coming year, according to a new national survey examining real-world experiences with medical costs and access.
The West Health-Gallup Center for Healthcare in America released its “State of the States 2025” study, which surveyed nearly 20,000 adults nationwide between June and August 2025. South Dakota ranked 21st out of 51 jurisdictions, earning a C+ overall grade. The state received a D+ for healthcare cost, and C+ grades for quality and access.
The survey found healthcare affordability remains a widespread concern nationwide. One in five Americans reported they or a household member could not afford prescription medications within the past three months. Nationally, 30 percent said they skipped doctor-recommended tests or procedures in the past year due to cost.
South Dakota’s ranking places it behind several neighboring states. Iowa tied with Massachusetts for first overall, while North Dakota ranked eighth, Nebraska 10th, and Minnesota 12th.
Researchers focused on patient experiences rather than traditional metrics, asking 27 questions about costs, appointment delays, and access to providers. Access challenges extended beyond affordability, with 26 percent of Americans reporting distance to care delayed treatment and 44 percent citing long wait times.
No state earned an A grade in any category, highlighting nationwide challenges with healthcare affordability and access. Even in top-performing states, at least 15 percent of residents reported difficulty affording prescriptions.
The study comes as healthcare costs continue to rise and workforce shortages persist following the pandemic, with policy debates ongoing at both the state and national levels.
Full state scorecards and survey data are available through West Health and Gallup.