Health insurance cost by state in 2026
The benchmark Silver premium ranges from $401 a month in New Hampshire to $1,286 in Vermont. Every figure below is computed from the CMS rate filings, county by county.
A state reinsurance program holds benchmark premiums down. Maryland is next at $410.
2026 benchmark Silver plan, 40 year old, weighted across every county.
Community rating, small risk pool, few insurers.
All 50 states and DC ranked, cheapest to most expensive
Individual is a 40-year-old non-tobacco benchmark Silver plan at full price. Family is the same benchmark priced for two adults age 40 plus two children aged 14 or under. The county range shows the cheapest and dearest county benchmark inside each state, because premiums are set by rating area, not statewide.
| Rank | State | Individual | Family of 4 | County range |
|---|---|---|---|---|
| 1 | New Hampshire | $401 | $1,281 | $388 to $440 |
| 2 | Maryland | $410 | $1,312 | $410 to $410 |
| 3 | Minnesota | $445 | $1,511 | $383 to $655 |
| 4 | Virginia | $455 | $1,455 | $435 to $494 |
| 5 | Indiana | $474 | $1,514 | $441 to $510 |
| 6 | Massachusetts | $490 | $1,508 | $471 to $525 |
| 7 | Idaho | $492 | $1,571 | $473 to $543 |
| 8 | Nevada | $500 | $1,599 | $470 to $830 |
| 9 | Iowa | $501 | $1,601 | $453 to $621 |
| 10 | Rhode Island | $501 | $1,603 | $501 to $501 |
| 11 | Ohio | $513 | $1,641 | $483 to $669 |
| 12 | Michigan | $525 | $1,679 | $388 to $910 |
| 13 | Arizona | $532 | $1,700 | $449 to $1,048 |
| 14 | Colorado | $539 | $1,725 | $504 to $886 |
| 15 | Hawaii | $541 | $1,730 | $541 to $541 |
| 16 | Oregon | $542 | $1,621 | $509 to $626 |
| 17 | New Jersey | $545 | $1,742 | $545 to $545 |
| 18 | South Carolina | $563 | $1,799 | $456 to $663 |
| 19 | North Dakota | $572 | $1,828 | $456 to $639 |
| 20 | Pennsylvania | $585 | $1,870 | $468 to $996 |
| 21 | Kentucky | $597 | $1,910 | $521 to $775 |
| 22 | Washington DC | $603 | $2,016 | $603 to $603 |
| 23 | Washington | $604 | $1,932 | $559 to $691 |
| 24 | Oklahoma | $605 | $1,934 | $561 to $818 |
| 25 | Missouri | $607 | $1,939 | $523 to $789 |
| 26 | Wisconsin | $609 | $1,948 | $541 to $778 |
| 27 | California | $613 | $1,959 | $464 to $1,098 |
| 28 | New Mexico | $632 | $2,020 | $524 to $734 |
| 29 | Georgia | $634 | $2,028 | $488 to $864 |
| 30 | North Carolina | $635 | $2,031 | $540 to $845 |
| 31 | Utah | $642 | $1,973 | $574 to $1,014 |
| 32 | Louisiana | $644 | $2,058 | $542 to $801 |
| 33 | Alabama | $645 | $1,931 | $597 to $686 |
| 34 | Illinois | $655 | $2,094 | $498 to $1,304 |
| 35 | South Dakota | $655 | $2,093 | $514 to $774 |
| 36 | Mississippi | $660 | $1,975 | $602 to $707 |
| 37 | Texas | $662 | $2,115 | $564 to $963 |
| 38 | Kansas | $668 | $2,136 | $579 to $958 |
| 39 | Florida | $683 | $2,185 | $572 to $1,272 |
| 40 | Delaware | $691 | $2,209 | $691 to $691 |
| 41 | Montana | $693 | $2,215 | $561 to $757 |
| 42 | Maine | $706 | $2,256 | $668 to $748 |
| 43 | Nebraska | $711 | $2,272 | $642 to $826 |
| 44 | Tennessee | $712 | $2,277 | $646 to $793 |
| 45 | Arkansas | $774 | $2,474 | $774 to $774 |
| 46 | New York | $791 | $3,165 | $579 to $1,050 |
| 47 | Connecticut | $856 | $2,736 | $791 to $926 |
| 48 | Alaska | $1,024 | $3,274 | $1,003 to $1,045 |
| 49 | West Virginia | $1,070 | $3,422 | $944 to $1,174 |
| 50 | Wyoming | $1,090 | $3,486 | $1,027 to $1,104 |
| 51 | Vermont | $1,286 | $5,144 | $1,286 to $1,286 |
Derived from the CMS Health Insurance Exchange public use files for plan year 2026 (rate, plan attributes and service area files, plus the state-based exchange files), the CCIIO geographic rating area definitions, and the CMS open enrollment county file. Public domain. Snapshot 2026-09-06. National average $615. HealthCare.gov states are weighted by county plan selections; state-based marketplace states by county population, which CMS does not publish selections for.
What drives state-level cost differences
Insurer competition
States with many competing marketplace insurers tend to have lower benchmark premiums. States with thin competition and small rural risk pools land in the most-expensive tier: Vermont $1,286, Wyoming $1,090, West Virginia $1,070, Alaska $1,024.
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.