Health Freedom Index

Health Freedom Index (HFI)

Welcome to the 2026 installment of our data project, published in partnership with the Center for Modern Health. The Health Freedom Index is a comparative assessment of the legal, regulatory, and policy environments governing healthcare access across the United States. The index compiles state-level data on the degree of choice and freedom available to patients, healthcare professionals, insurers, and entrepreneurs. Individual measures are used to produce scores for each state, as well as the overall ranking. In addition to providing state rankings, the project aims to promote transparency and informed discussions about the role of freedom, voluntary exchange, and institutional design in American healthcare. It does not measure health outcomes. 

Together, these categories provide a comparative picture of how much freedom patients, healthcare professionals, insurers, entrepreneurs, and institutions have to make voluntary healthcare decisions within each state. Each variable in the index is scored on a freedom-oriented scale from 1 to 5, with higher scores indicating a less restrictive policy environment. The variables are then grouped into five categories scores and combined into an overall Health Freedom score for each state and D.C. 

This report is designed to be a useful resource and a conversation starter for those seeking to expand choice, competition, innovation, and voluntary exchange in American healthcare. By making state policy environments more transparent and comparable, we aim to support a more informed discussion about how states can remove unnecessary barriers and create more open health systems. 

The 2026 Health Freedom Index is a joint research effort between the Center for Modern Health and the Knee Regulatory Research Center at West Virginia University. The identical report and data can be downloaded from the Center for Modern Health website.