Overview
- The Commonwealth Fund on Wednesday released a 2026 state-by-state review showing racial and ethnic gaps in access, quality, and outcomes across all 50 states.
- Black people face the highest rates of premature and avoidable death in every state with data, and Black women die of breast cancer at the highest rates despite high screening because follow-up care is often not covered.
- Texas ranks near the bottom for Hispanic performance, and in most states Hispanic adults are the most likely to skip needed care because of cost and to lack a regular source of care.
- Performance varies widely by state, with Connecticut, Maryland, Massachusetts, New York, and Rhode Island doing better across groups, while Arkansas, Mississippi, Oklahoma, and West Virginia show the steepest gaps; high-scoring Minnesota still has poor outcomes for American Indian and Alaska Native residents and below-average results for Black Minnesotans.
- Researchers say recent moves in 2025 and 2026 are not yet in the data and are likely to widen disparities, including Medicaid funding cuts, the end of enhanced ACA tax credits that raised marketplace premiums, and stricter immigration rules that deter people from seeking care.