2025 Hawaiʻi Healthcare Scorecard — How Our State Measures Up

November 25, 2025

The 2025 West Health–Gallup Healthcare Scorecard provides an in-depth look at how residents across the country experience the healthcare system, rating each state’s performance on cost, quality, and access. Hawaiʻi received an overall grade of C+, placing us #24 out of 50 states plus D.C.  While our state performs better than many others, the data also reveal meaningful challenges that affect families throughout our islands.

Affordability: Hawaiʻi’s Strongest Area

Hawaiʻi ranked #12 nationally in cost, earning a C-. This is Hawaiʻi’s highest score across all categories and suggests that, relative to the rest of the country, healthcare here is more affordable. But affordability does not mean families are thriving. When surveyed, nearly one-third of Hawaiʻi residents reported taking difficult steps just to pay for healthcare in the past year. According to the data, residents said they:

• Cut back on utilities (12%)
• Borrowed money (12%)
• Skipped meals (9%)
• Drove less to save gas (12%)
• Stretched or cut doses of current prescriptions (16%)

These numbers show that, even in a top-tier cost state, many Hawaiʻi families still face financial strain when medical needs arise.

Quality: A Solid Middle-Tier Rating

Hawaiʻi earned a C+ for quality, ranking #23 in the nation. This indicates that while residents generally report positive experiences with the care they receive, the state does not stand out as a national leader. The rating suggests acceptable levels of patient satisfaction but room for improvement in areas such as provider communication, timeliness, and overall outcomes. 

Access: Hawaiʻi’s Most Significant Challenge

The greatest concern revealed in the scorecard is access, where Hawaiʻi received a C and ranked #39 nationwide. Access barriers are consistently reported across the islands — from neighbor-island families who struggle to reach specialized care to residents on Oʻahu facing long wait times and limited appointment availability.

Survey data also highlights mental health access as a major pressure point. When asked what might prevent them from seeking mental-health treatment if needed, Hawaiʻi residents said:

• It’s hard to find available providers (38%)
• Doubts about whether treatment would help (31%)
• Shame or stigma (28%)
• Cost concerns (17%)

These findings reflect systemic shortages of mental-health professionals and ongoing cultural and logistical barriers that prevent people from getting timely care.

What the Scorecard Means for Hawaiʻi Families

Taken together, these results reveal a mixed picture: Hawaiʻi performs better than most states in affordability and maintains acceptable quality, but the system continues to fall short in making care accessible to everyone. This is especially true for mental-health services, rural and neighbor-island communities, and residents navigating chronic health conditions.

For policymakers, advocates, and faith-based organizations, the scorecard provides a clear roadmap for where improvements are needed most. Strengthening access, supporting workforce development, expanding mental-health services, and addressing neighbor-island disparities are key opportunities to improve the wellbeing of Hawaiʻi’s keiki, kūpuna, and ʻohana statewide.