Health insurance cost by state in 2026
The benchmark Silver premium ranges from $401 a month in New Hampshire to $1,299 in Vermont. Your state matters more than your plan choice.
A state reinsurance program holds benchmark premiums down. Maryland is next at $414.
2026 benchmark Silver plan, 40 year old (KFF).
Community rating, small risk pool, few insurers.
All 50 states ranked, cheapest to most expensive
Individual is a 40-year-old non-tobacco benchmark Silver plan, full price (KFF 2026). Family is two adults age 40 plus two children, derived from the state benchmark via the federal age curve.
| Rank | State | Individual | Family of 4 |
|---|---|---|---|
| 1 | New Hampshire | $401 | $1,282 |
| 2 | Maryland | $414 | $1,324 |
| 3 | Minnesota | $448 | $1,432 |
| 4 | Virginia | $455 | $1,455 |
| 5 | Indiana | $474 | $1,515 |
| 6 | Idaho | $490 | $1,567 |
| 7 | Massachusetts | $494 | $1,579 |
| 8 | Nevada | $497 | $1,589 |
| 9 | Iowa | $501 | $1,602 |
| 10 | Rhode Island | $506 | $1,618 |
| 11 | Ohio | $513 | $1,640 |
| 12 | Michigan | $523 | $1,672 |
| 13 | Arizona | $532 | $1,701 |
| 14 | Hawaii | $541 | $1,730 |
| 15 | Oregon | $543 | $1,736 |
| 16 | New Jersey | $545 | $1,742 |
| 17 | Colorado | $557 | $1,781 |
| 18 | South Carolina | $564 | $1,803 |
| 19 | California | $570 | $1,822 |
| 20 | North Dakota | $570 | $1,822 |
| 21 | Pennsylvania | $572 | $1,829 |
| 22 | Kentucky | $590 | $1,886 |
| 23 | Oklahoma | $604 | $1,931 |
| 24 | Missouri | $605 | $1,934 |
| 25 | DC | $610 | $1,950 |
| 26 | Wisconsin | $611 | $1,953 |
| 27 | Washington | $612 | $1,957 |
| 28 | Georgia | $615 | $1,966 |
| 29 | New Mexico | $623 | $1,992 |
| 30 | North Carolina | $638 | $2,040 |
| 31 | Utah | $640 | $2,046 |
| 32 | Alabama | $645 | $2,062 |
| 33 | Illinois | $646 | $2,065 |
| 34 | Louisiana | $646 | $2,065 |
| 35 | South Dakota | $655 | $2,094 |
| 36 | Texas | $661 | $2,113 |
| 37 | Mississippi | $662 | $2,116 |
| 38 | Kansas | $670 | $2,142 |
| 39 | Florida | $683 | $2,184 |
| 40 | Delaware | $691 | $2,209 |
| 41 | Montana | $692 | $2,212 |
| 42 | Maine | $709 | $2,267 |
| 43 | Nebraska | $710 | $2,270 |
| 44 | Tennessee | $711 | $2,273 |
| 45 | Arkansas | $774 | $2,474 |
| 46 | New York | $817 | $2,612 |
| 47 | Connecticut | $870 | $2,781 |
| 48 | Alaska | $1032 | $3,299 |
| 49 | West Virginia | $1073 | $3,430 |
| 50 | Wyoming | $1090 | $3,485 |
| 51 | Vermont | $1299 | $4,153 |
Source: KFF State Health Facts, 2026 average benchmark (second-lowest-cost Silver) premium for a 40-year-old. National average $625. Family figures derived via the federal default age curve.
What drives state-level cost differences
Insurer competition
States with many competing marketplace insurers (California $570, Massachusetts $494, Pennsylvania $572) tend to have lower benchmark premiums. States with thin competition and small rural risk pools (Vermont $1,299, Alaska $1,032, Wyoming $1,090, West Virginia $1,073) consistently land in the most-expensive tier.
State reinsurance programs
Maryland, Minnesota, New Jersey, and others run reinsurance pools that absorb the highest claims. These programs can lower benchmark premiums by 10 to 25 percent. Reinsurance is funded by insurer assessments and federal Section 1332 waivers.
Population health and density
Rural states with older populations (Wyoming, West Virginia, Vermont) carry higher per-capita claim costs. Urban states with younger workforces (DC, Massachusetts, Utah) benefit from healthier risk pools.
Community rating exceptions
Vermont, New York, and Massachusetts forbid age-based pricing within their marketplaces. Everyone pays the same rate, which raises young adult premiums while lowering older adult premiums. The published "average" therefore looks high.