(The Center Square) – Ahead of upcoming premium hikes, a report published Monday ranked Spokane as the ninth-highest city nationwide for where people spend the most on health care and basic medications.
According to personal finance website WalletHub, Spokane is the only Northwest city to land in the top 10. The study compared the costs of doctor, dentist and optometrist visits with the prices of ibuprofen and insulin across some of the largest cities nationwide. Seattle ranked 74th and Portland ranked 41st, according to Monday’s report.
The main metric associated with each position is the cost of health care as a share of median monthly household income. Spokane families make tens of thousands of dollars less than those in Seattle and Portland, but pay a larger share of their income for relatively the same basic care and medications.
“As health care gets increasingly more expensive, more and more people find themselves struggling to afford essential services and medicines,” Chip Lupo, WalletHub analyst and writer, wrote in the report.
He said some cities have lower prices than elsewhere, but the average income may still not be enough to keep pace with rising costs, even outside health care. Detroit, Mich., topped the chart, with 13.17% of median monthly income spent on health care, while Gilbert, Ariz., was the cheapest city at 3.54%.
Spokane households spend 9.16% of the median monthly income on health care, behind New Orleans, La., at 9.28%, but just ahead of Baton Rouge, La., at 9.01%. WalletHub cited federal data showing an 11.8% increase in costs over the last five years, underscoring the importance of an emergency fund.
Government employees aren’t immune to those costs, nor are local taxpayers. Mayor Lisa Brown warned city staff in October that her administration is meeting with union leadership following a significant rise in medical claims over the past year. One email says medical premiums could increase by 25% in 2026.
“It is important to remember that benefit premiums are composed of both an employer contribution and an employee contribution,” Brown wrote in an email on Oct. 14. “We share this news with heavy hearts. We will continue to evaluate all our options and communicate with you as often as possible.”
City Administrator Alex Scott and Chief Financial Officer Matt Boston told the Spokane City Council at the time that the increase would help rebuild reserves in the Employee Benefits Fund. They backfilled $8 million from reserves last month just to keep the benefits fund solvent through the end of 2025.
According to census data, Spokane’s median household income from 2019 to 2023 was $65,745, 44% below the statewide median and 19.4% below the nationwide median. So, despite paying roughly the same amount, Spokane households spend a far larger share of their monthly paychecks on health care than Seattle households, which had a median annual income of $121,984 across that same period.
The Spokane Regional Health District did not respond to The Center Square before publishing on Monday.
“While some cities have lower prices than others, the average income in many places still may not be enough to keep up with the costs,” Lupo wrote in the WalletHub study, “especially when consumers have also faced inflated prices across all other facets of their budgets over the past few years.”
