Health insurance cost by state in 2026
Health insurance ranges from $480 a month in Maryland to $1,224 in Vermont. Your state matters more than your plan choice.
State-based reinsurance program absorbs high-cost claims.
2026 individual marketplace Silver plan, 40 year old.
Community rating, small risk pool, two insurers.
All 50 states ranked, cheapest to most expensive
Individual is a 40-year-old non-tobacco benchmark Silver plan, full price. Family is two adults plus two children. YoY shows the change from 2025 to 2026.
| Rank | State | Individual | Family | YoY | Insurers | Marketplace |
|---|---|---|---|---|---|---|
| 1 | Maryland | $480 | $1,442 | +17% | 5 | state |
| 2 | Hawaii | $510 | $1,530 | +15% | 2 | federal |
| 3 | Massachusetts | $518 | $1,554 | +12% | 9 | state |
| 4 | Minnesota | $519 | $1,556 | +14% | 4 | state |
| 5 | Utah | $522 | $1,567 | +19% | 5 | federal |
| 6 | DC | $530 | $1,591 | +14% | 2 | state |
| 7 | Rhode Island | $530 | $1,591 | +13% | 2 | state |
| 8 | Idaho | $549 | $1,646 | +21% | 5 | state |
| 9 | Michigan | $559 | $1,678 | +22% | 9 | federal |
| 10 | Pennsylvania | $561 | $1,683 | +16% | 8 | state |
| 11 | Nevada | $561 | $1,684 | +18% | 6 | state |
| 12 | Arizona | $562 | $1,685 | +22% | 6 | federal |
| 13 | New Mexico | $562 | $1,685 | +19% | 5 | state |
| 14 | Ohio | $568 | $1,704 | +23% | 11 | federal |
| 15 | New Hampshire | $572 | $1,718 | +18% | 4 | federal |
| 16 | Washington | $575 | $1,726 | +20% | 11 | state |
| 17 | Indiana | $575 | $1,726 | +21% | 8 | federal |
| 18 | Virginia | $580 | $1,740 | +23% | 7 | state |
| 19 | Arkansas | $581 | $1,742 | +19% | 4 | partnership |
| 20 | Oregon | $591 | $1,773 | +19% | 6 | state |
| 21 | Georgia | $599 | $1,796 | +24% | 7 | state |
| 22 | New Jersey | $600 | $1,799 | +22% | 5 | state |
| 23 | Illinois | $600 | $1,799 | +20% | 7 | state |
| 24 | Texas | $600 | $1,799 | +20% | 11 | federal |
| 25 | Tennessee | $600 | $1,799 | +23% | 5 | federal |
| 26 | Kentucky | $614 | $1,840 | +21% | 5 | state |
| 27 | Colorado | $619 | $1,856 | +17% | 7 | state |
| 28 | Kansas | $619 | $1,856 | +24% | 5 | federal |
| 29 | Missouri | $619 | $1,856 | +25% | 6 | federal |
| 30 | Oklahoma | $619 | $1,856 | +22% | 5 | federal |
| 31 | South Carolina | $631 | $1,893 | +22% | 5 | federal |
| 32 | Louisiana | $631 | $1,893 | +22% | 4 | federal |
| 33 | California | $644 | $1,932 | +24% | 12 | state |
| 34 | Florida | $644 | $1,932 | +26% | 9 | federal |
| 35 | Mississippi | $644 | $1,932 | +24% | 4 | federal |
| 36 | Montana | $644 | $1,932 | +21% | 3 | federal |
| 37 | North Dakota | $650 | $1,949 | +23% | 4 | federal |
| 38 | Alabama | $656 | $1,969 | +25% | 4 | federal |
| 39 | North Carolina | $656 | $1,969 | +23% | 6 | federal |
| 40 | New York | $656 | $1,969 | +18% | 12 | state |
| 41 | Wisconsin | $656 | $1,969 | +21% | 12 | federal |
| 42 | South Dakota | $662 | $1,986 | +24% | 3 | federal |
| 43 | Maine | $700 | $2,099 | +17% | 4 | state |
| 44 | Nebraska | $700 | $2,099 | +22% | 3 | federal |
| 45 | Delaware | $718 | $2,154 | +21% | 2 | federal |
| 46 | Iowa | $718 | $2,154 | +22% | 4 | federal |
| 47 | Connecticut | $730 | $2,189 | +19% | 3 | state |
| 48 | West Virginia | $749 | $2,247 | +23% | 2 | federal |
| 49 | Wyoming | $842 | $2,526 | +21% | 2 | federal |
| 50 | Alaska | $910 | $2,731 | +19% | 2 | federal |
| 51 | Vermont | $1004 | $3,012 | +16% | 2 | state |
Source: KFF marketplace tracking, CMS rate filings 2026, weighted by enrollment for benchmark Silver plans.
What drives state-level cost differences
Insurer competition
States with five or more competing marketplace insurers (California, Massachusetts, Pennsylvania, Texas) tend to have lower benchmark premiums. States with two or fewer (Vermont, Alaska, Wyoming, Delaware) 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.