The survey looked at 3,137 counties nationwide, all but seven, and said average rates increased by 271 percent in Buchanan County.
The reason given for the spike: The Affordable Care Act.
"Everyone is required to buy insurance," said Rob Schaaf, a state senator from St. Joseph and also a local physician. "It created a community rating based on those three age groups. It turns out men have to subsidize the care of women and younger people have to subsidize the care of old people."
"You get penalized for being healthy because you're paying a higher premium than before," said R.T. Turner, presiding commissioner for Buchanan County.
Turner doesn't like to see Buchanan County at the top of any list like the Forbes report, but he's not overly concerned.
"Percentages can be a little misleading," he said. "Bottom line is, what is everyone all paying? Are we all paying about the same? Were we way cheaper than a lot of communities in the past?"
As some might be concerned businesses wanting to locate in St. Joseph might reconsider because of these statistics, Turner says these figures are for individual policies while group rates are figured differently.
"My experience with businesses coming in and recruiting businesses, they're interested in that you have good healthcare, a good hospital and you have good doctors here that can provide employees," he said.
However, that doesn't help those who need an individual policy. What answer is there for them?
"The answer is we need healthcare competition," Schaaf said. "The reason costs are so high in Buchanan County is that we have only one healthcare system. Costs have always been high. We need more competition in the healthcare market, plain and simple."
Buchanan County's number one ranking was for men ages 27, 40 and 64.
Some areas of the country actually saw rate decreases.
To review the entire survey, click here.