How the Northeast Became a Leader in Healthcare

Every summer in Millville, New Jersey, a section of Pine Street is closed to cars. Instead, kids and families fill the street for games like Wiffle ball and Hula-Hoops. Community health workers also set up stands to talk with residents about staying healthy. Programs like this one are part of why New Jersey and its neighbors in the Northeast rank among the best states in the country for healthcare.

According to the U.S. News 2026 Best States Rankings, New Jersey ranked No. 6 overall in Healthcare and No. 1 in Public Health. Massachusetts, Connecticut, and Rhode Island took the next top spots, finishing second, third, and fourth. These northeastern states have become leaders by finding new ways to make healthcare easier to access and more affordable. The whole country struggles with high healthcare costs, but the Northeast has worked harder than most to fix the problem.

One big reason these states do so well is that more of their residents have health insurance. Massachusetts has had the lowest share of uninsured people in the nation since 2006. Rhode Island also ranked near the top for health insurance enrollment. When more people have insurance, they are more likely to visit a doctor before a small health problem becomes a big one. That early care makes a huge difference in keeping people healthier overall.

Massachusetts got its head start in 2006, when it passed a major healthcare law called Chapter 58. That law required people over 18 to sign up for health insurance. It also created the Massachusetts Health Connector, a marketplace where residents could find insurance plans at lower prices. This law later became the model for the national Affordable Care Act, which was passed in 2010.

Today, most states in the Northeast run their own health insurance marketplaces instead of relying on the federal government's system. John E. McDonough, a public health professor at Harvard, says this approach works better. When states run their own systems, they can tailor programs to fit the needs of their own residents. He says states also have their reputation on the line, which gives them a strong reason to make the programs work.

These states also focus heavily on prevention — stopping health problems before they start. In Rhode Island, a program required insurance companies to put more money into primary care, which means regular doctor visits and check-ups. Cory King, Rhode Island's health insurance commissioner, said that access to primary care is essential for preventing and managing chronic disease. Getting regular care can also help lower costs over time, since treating a disease early is cheaper than treating it after it gets worse.

The Northeast also showed stronger results in children's health. More children in Massachusetts and New Jersey received early health screenings through Medicaid, a government insurance program for low-income families. Connecticut and Maryland led the country in preventive dental visits for kids. Rates of obesity, smoking, and suicide were also lower across the region compared to other parts of the country.

Even so, keeping healthcare costs from rising is a tough challenge. In Massachusetts, total healthcare spending grew by 5.7% in 2024, which was well above the state's goal of 3.6%. The state has a spending watchdog agency called the Health Policy Commission, but costs have still gone up four years in a row. Rhode Island has tried voluntary programs to slow spending growth, but officials admit those have limits.

Experts say that good health outcomes often depend on three things: health insurance coverage, higher incomes, and education. McDonough points out that states with lower rankings often face bigger challenges and have to work even harder to improve public health. He also argues that government must play a bigger role in controlling costs, since competition alone has not worked well enough.

Megan Sheppard, the chief health officer for Cumberland County in New Jersey, says the key is staying connected to communities. Programs like PlayStreets on Pine Street show that simple ideas can make a big impact on public health. As states look to the future, experts agree that staying flexible and willing to try new things will be just as important as the policies already in place.