The United States achieves a mediocre score and ranks 23rd in the world and last among G7 countries. The United States ranks at the top for public spending on health care as a proportion of total government spending, but millions of people lack health insurance and experience poor health outcomes. Spending on education is also relatively high, but unevenly distributed. Spending on social protection is low relative to other rich countries. The US labor rights score is very inadequate for a rich country, with a minimum wage below what is needed to keep working families above the poverty line and unchanged since 2009. The United States is one of only five countries in the world lacking mandatory paid parental leave. We expect the US score to fall in next year’s index as a result of the tax reform that came into force this year.