30% cost of living
The single largest weight - a family of four's everyday budget tracks the cost index closely. Lower is better.
The 10 Best States for Families in 2026
Composite ranking on cost of living (30%), childcare affordability (25%), healthcare access (20%), median income (15%) and Medicaid expansion (10%). Sourced from BEA Regional Price Parities, Child Care Aware, KFF, Census ACS and CMS.
Top 10
Family composite ranking
| Rank | State | Score | COLI | Childcare % income | Uninsured % | Median income |
|---|---|---|---|---|---|---|
| 1 | North Dakota | 85.4 | 89.0 | 14.8% | 6.8% | $66,519 |
| 2 | Iowa | 84.8 | 87.8 | 16.6% | 4.8% | $65,573 |
| 3 | Kentucky | 83.5 | 90.2 | 14.2% | 5.3% | $55,573 |
| 4 | Nebraska | 81.7 | 90.1 | 18.4% | 6.5% | $65,720 |
| 5 | Arkansas | 81.5 | 86.9 | 14.4% | 8.4% | $52,528 |
| 6 | Delaware | 80.5 | 99.8 | 17.1% | 5.9% | $72,724 |
| 7 | Utah | 80.4 | 98.9 | 15.1% | 8.5% | $74,197 |
| 8 | New Hampshire | 80.1 | 104.2 | 19.0% | 5.5% | $83,449 |
| 9 | Idaho | 80.1 | 95.5 | 15.3% | 8.2% | $63,527 |
| 10 | Maryland | 80.0 | 105.0 | 18.7% | 6.0% | $87,063 |
Sources: BEA Regional Price Parities by state (table SARPP, 2024 reference year, released 19 February 2026), Child Care Aware of America 2024 "Price of Care", KFF state health data, Census ACS 5-year, CMS Medicaid expansion status.
Why this ranking
What we weight, and why.
25% childcare affordability
Childcare can claim 13-25% of household income for an infant. BEA publishes no childcare parity, so the price index does not capture it; we add it explicitly.
20% healthcare access
Combined: lower uninsured rate plus more hospitals per capita. Families with kids interact with the healthcare system often.
15% median income
A cheap state with low wages still works only if the household can earn locally. We normalise against $90,000.
10% Medicaid expansion
Binary signal of state policy posture toward low-and-middle-income family healthcare access.
Not weighted
K-12 school quality - too much intra-state variation. Crime - varies by neighborhood. Climate - personal preference. Treat the score as the financial layer; layer your own priorities on top.
Frequently Asked
Best states for families, answered
What makes a state good for families?
Affordable housing, manageable childcare cost as a share of income, healthcare access (low uninsured rate + hospitals per capita + Medicaid expansion), strong median income and reasonable public schools. The ranking on this page weights these factors with 30% cost, 25% childcare affordability, 20% healthcare access, 15% income and 10% Medicaid expansion.
Why isn't a low-cost-of-living state always best?
Mississippi has the cheapest cost of living but high uninsured rates (11.8%), no Medicaid expansion and median household income of $46,511 - the lowest in the US. Cheap doesn't always mean family-friendly. The composite ranking penalises low income and weak healthcare even when cost is low.
How does childcare affordability factor in?
Childcare for an infant in a daycare center can cost 13-25% of median household income depending on state. The ranking penalises high childcare percentages because they represent a real cost-of-living drag for working families that the price index does not capture: BEA publishes no childcare parity.
Why are Plains and Upper Midwest states well-represented?
States like South Dakota, Iowa, Nebraska and North Dakota combine sub-100 cost of living, lower childcare cost percentages, decent healthcare access (high hospitals-per-capita in rural states) and median incomes around $63-66k. The trade-off is winter weather, smaller job markets and less cultural variety than coastal states.
What about school quality?
We do not include K-12 outcomes in the composite for two reasons: (1) school quality varies dramatically by school district within a state, so state averages mask the actual decision relevant to a family (which school district to live in); (2) the existing US News Best States rankings already cover this and we do not want to duplicate. Treat the cost + childcare + healthcare ranking on this page as the financial layer and use district-level school data separately.
Are no-income-tax states automatically family-friendly?
Not necessarily. Texas has no income tax but the second-highest uninsured rate in the country (17.3%), no Medicaid expansion and high property tax. Florida has no income tax but 12.7% uninsured and no Medicaid expansion. The income-tax benefit can be offset by healthcare access and other costs.