Rich Americans Are Moving Abroad — It’s Not Just for Taxes Anymore

Wealthy Americans are choosing to leave the United States for places overseas, and it’s not just because of low taxes and nicer lifestyles. A new global trend shows that health care costs and access to care are now major reasons why some rich families are picking new homes in other countries.

Experts call this trend “millionaire migration.” It means people with a lot of money are choosing where to live based on both money and quality of life issues — especially how expensive or easy it is to get good private health care.

Why Rich Americans Are Moving

Traditionally, rich Americans have moved abroad for:

• Lower taxes on income and wealth.
• Better lifestyle options (weather, space, privacy).

But now, health care costs and access are becoming big parts of the decision too. Many wealthy people are worried about rising health insurance premiums and the high cost of private medical care in the U.S. They are looking for countries where medical costs are lower and care is more affordable. 

In the U.S., private health insurance can cost about $18,000 a year per person — one of the highest in the world — which even wealthy families notice as they age and need more care.

Where Wealthy People Are Moving

Analysis of recent data shows:

• Many rich Americans are applying for residence or citizenship in other countries.
• In 2025, an estimated 142,000 millionaires moved across borders, the highest number recorded so far. That number may rise to around 165,000 in 2026.
• Countries with **lower health-care costs and better health insurance options are often chosen over just low-tax locations.

Some places listed as more health-care friendly include nations in Europe, Asia, and Africa where private insurance costs less and access to good hospitals is easier.

Health Care Costs Are a Big Factor

Experts say that for many wealthy households, health care is the biggest long-term monthly cost after housing and schooling. When thinking about retirement and aging, the cost of care becomes even more important.

For example:

• Paying $30,000 or more for private health insurance can be a concern, even for millionaires.
• Some countries offer similar quality care for a fraction of that price, making them attractive to people thinking about long-term health and finances. 

Some States Are Losing Wealthy Residents

Within the U.S., wealthier people are leaving certain states where living costs and taxes are high. States like California and New York have seen people relocate to other states or countries.

Experts say this shift might affect local economies, because wealthy residents often:

• Spend money locally (luxury goods, restaurants, real estate).
• Invest in businesses and create jobs.
• Support local tax bases.

When wealthy households move away, local spending and investment may fall, especially in expensive metropolitan areas.

What This Means for the Future

The pattern of rich people moving abroad signals some big economic trends:

• Health care costs are becoming a central financial issue, even for the wealthy.
• Global mobility — the ability to live and work across borders — is now part of wealth planning.
• Countries that offer better health care access at lower cost may attract more affluent residents and investment.

Economists say this migration may also show broader stress in the U.S. health care system — something that affects people from all income levels, not just the rich.

Bottom Line

Wealthy Americans are increasingly choosing where to live not just for tax breaks or lifestyle, but also for health care affordability and access. This new focus on health costs is helping drive a rise in “millionaire migration” around the world and could reshape economic patterns in both the U.S. and countries gaining these wealthy residents.