Big Careers & Costly Care for Expats in the USA in 2026

The USA offers expats strong career prospects and a friendly welcome, but healthcare costs and work-life balance are real burdens.

➡️You’re welcome to use these 2026 Expat Insider results. Please remember to credit InterNations as the source, and where possible, include a link to www.internations.org.

In this article:

In Brief
Lovely Locals vs. Visa Woes
Strong Prospects, Poor Balance
A Disappointing Quality of Life
Squeezed Finances
The Typical Expat in the USA
Further Reading

In Brief

The USA ranks 20th out of 31 destinations in the Expat Insider 2026 survey. Its strengths are Expat Essentials (7th) and the Ease of Settling In (9th), followed by a mid-table result in the Working Abroad Index (16th). The Personal Finance Index (24th) is weaker, and the USA ranks dead last for Quality of Life (31st).

All things considered, about seven in ten expats (69%) are happy with life there, mostly in line with the global average (70%).

Lovely Locals vs. Visa Woes

The USA ranks 9th in the Ease of Settling In Index, including 9th places for both locals’ friendliness towards foreign residents and the ease of making local friends. In fact, expats in the USA are less likely to be friends with only fellow expats (27% vs. 37% globally). They also have hardly any problems getting used to the local culture, with over two-thirds (68%) agreeing it’s easy (vs. 60% globally).

Opinion

It's an easy place to live. Lots of opportunity and people are friendly. (Jamaican expat in Orlando)

Opinion

Practical life is smooth too, with the country placing 7th in the Expat Essentials Index. Expats appreciate the ease of opening a local bank account (6th), getting high-speed internet set up (8th), or paying without cash (9th). Around half even agree that it’s easy for expats to find housing in the US (51% vs. 44% globally) and to deal with the local bureaucracy (45% vs. 38%).

The one big snag in the index is getting a visa, with the USA ranking in the bottom 3 for this point (29th).

Strong Prospects, Poor Balance

The USA places 16th in the Working Abroad Index. The highlight here is clearly the Career Prospects Subcategory (3rd). It’s 4th for the local job market and 5th for improved career opportunities, with two-thirds (67%) agreeing that relocating to the US has improved their prospects (vs. 55% globally). Interestingly, these results stand in stark contrast to a state of the economy that has seen better days (25th).

The big trade-off is time: the country ranks last for work-life balance (31st), with only 50% satisfied with this factor (vs. 62% globally).

Opinion

The lack of work-life balance when you start a family is debilitating, in my opinion. (French expat in Aurora, CO)

Opinion

Respondents also worry about their job security in the US (25th). Pay can be high, though — over one in ten expats (11%) report an annual gross income above 250,000 USD, far beyond the 4% global share.

A Disappointing Quality of Life

The USA receives its worst results for Quality of Life, ranking last (31st). Healthcare is the worst element: expats don’t consider medical care easily available (27th), nor affordable (31st) or of particularly good quality (26th). In fact, fewer than one in five expats (19%) are satisfied with medical costs (vs. 61% globally).

The public transport infrastructure is nothing to write home about either, with respondents pointing towards a lack of availability (31st) and high costs (26th). Only the infrastructure for cars receives some praise, with close to four in five (79%) saying it’s good (vs. 73% globally).

However, the USA gets dragged down further in the index by a last place for political stability (31st) — with 42% giving it a negative rating (vs. 17%) — and bottom 5 result for personal safety (27th). Worldwide, over four in five expats (81%) feel safe in their new home abroad. In the USA, this is true for less than two-thirds (66%).

The Leisure Options Subcategory (12th) is the sole bright spot in the index.

Squeezed Finances

The high cost of living was a leading pre-move concern for 32% of expats — along with the distance from home (35%). And in fact, once in the country, only about a quarter of expats (27%) rate costs in the USA positively (vs. 39% globally).

Unsurprisingly then, the share of respondents who agree that their disposable household income is enough for a comfortable life is also below average (66% vs. 71%), leading to the country’s overall 24th place in the Personal Finance Index.