Nearly half of South Dakotans worry they won’t be able to afford needed healthcare in the coming year, according to a new national survey highlighting ongoing concerns about medical costs and access.
South Dakota ranked 21st out of 51 jurisdictions in the West Health–Gallup “State of the States 2025” report, earning C+ overall, with a D+ for cost and C+ grades for quality and access. The survey, based on nearly 20,000 responses, asked residents about real‑world experiences such as skipping care due to cost and waiting for appointments.
Nationally, one in five Americans said they or a household member couldn’t afford a prescription in the past three months.
South Dakota trailed several Northern Plains neighbors: Iowa tied for first, while North Dakota ranked eighth, Nebraska 10th, and Minnesota 12th.
No state earned an A grade in any category. Even in top‑ranked states, 15 percent of residents reported being unable to afford prescriptions.
Affordability gaps were widest in lower‑ranked states, where up to 46 percent of residents skipped recommended medical tests due to cost. Nationwide, 30 percent avoided doctor‑recommended procedures in the past year.
Access barriers extended beyond cost: 26 percent of Americans delayed care because of distance, and 44 percent faced long wait times for appointments.
Alaska, Arkansas and Texas ranked lowest overall, while Iowa and Massachusetts topped the list.
The survey was conducted between June and August 2025.
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