Average ACA Marketplace Health Insurance Premium by State, 2026
Average ACA Marketplace Health Insurance Premium by State, 2026
West Virginia has the highest average 2026 ACA Marketplace premium in the CMS state-level Open Enrollment data at $1,314 per person per month, followed by Wyoming at $1,217 and Vermont at $1,090. Idaho has the lowest state average at $509.
The ranking uses CMS Average Premium (Avg_Prm): the average monthly premium per person before advance premium tax credits, or APTC, among consumers with a 2026 Qualified Health Plan selection. It is not a benchmark Silver premium and does not show what a subsidy-eligible consumer necessarily pays after financial assistance.
Source type: official CMS Marketplace Open Enrollment data. Coverage: all 50 states plus the District of Columbia. Unit: U.S. dollars per person per month. Direction: higher average premium ranks higher. Status counts: 51 official_value; 0 calculated_value; 0 official_forecast; 0 modeled_projection.
West Virginia ranks first by CMS Avg_Prm for 2026 QHP selections.
Idaho has the lowest published Avg_Prm among the 50 states.
National consumer-level average before APTC; not an equal-weight average of the 51 jurisdiction values.
50 states plus DC; all ranking rows are official 2026 values.
Overview: what the 2026 Marketplace premium ranking measures
CMS Avg_Prm measures the average monthly gross premium across consumers with a 2026 QHP plan selection. For HealthCare.gov states, CMS allocates policy-level premiums among covered members using applicable age and tobacco rating factors.
The figures are not the second-lowest-cost Silver benchmark premium, a quote for a fixed-age consumer, the cheapest available plan or an insurer's percentage rate increase.
State averages also reflect the mix of consumers and plans selected. Differences can reflect underlying insurance prices, age distribution, geographic rating areas, metal-level choices and other characteristics represented in Marketplace plan selections. The ranking does not isolate the effect of any single factor.
How to read the ranking: a higher rank means a higher average gross Marketplace premium. It does not automatically mean that subsidy-eligible consumers pay more out of pocket.
Top 10 states with the highest average ACA Marketplace premiums in 2026
Five states exceed $1,000 per person per month in the CMS Avg_Prm data: West Virginia, Wyoming, Vermont, Alaska and Connecticut.
Highest average monthly Marketplace premium before APTC, 2026
| Rank | State | Average premium | Region / Note |
|---|---|---|---|
| 1 | West Virginia | $1,314 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 2 | Wyoming | $1,217 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 3 | Vermont | $1,090 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 4 | Alaska | $1,043 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 5 | Connecticut | $1,030 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 6 | Maine | $913 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 7 | Delaware | $901 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 8 | New Mexico | $842 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 9 | Arkansas | $839 | SBE-FP; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 10 | Tennessee | $838 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
Chart: Top 20 state-level Marketplace premium averages
Methodology
The ranking uses the official CMS 2026 Marketplace Open Enrollment State-Level Public Use File. The premiums are published 2026 observations, not forecasts or modeled estimates.
Metric
CMS Avg_Prm: average monthly premium per person before APTC among consumers with a 2026 Qualified Health Plan selection.
Unit and direction
U.S. dollars per person per month. Higher published Avg_Prm ranks higher.
Coverage
All 50 states plus the District of Columbia are included, for 51 state-level jurisdictions.
Status
51 official_value rows; no calculated values, official forecasts or modeled projections.
Inclusion and exclusion
Included: every state and the District of Columbia with a published 2026 CMS Avg_Prm value in the state-level OEP dataset. Excluded: none. No jurisdiction is omitted for a missing premium value.
Source hierarchy
CMS is the sole primary numeric source. Other CMS documents are used only to define variables, explain methodology, verify Marketplace platform classifications and provide national context.
Ranking and rounding
Published Avg_Prm values are sorted from highest to lowest. No values are recalculated or imputed. Displayed premiums reproduce the precision published in the state-level dataset.
Assumptions
No analytical assumptions are applied beyond CMS definitions. No missing state values are estimated, no conflicting values are averaged and no projection method is used.
How CMS calculates Avg_Prm
CMS defines the measure on a per-member, per-month basis. For HealthCare.gov states, policy-level premiums are allocated among covered members using applicable age and tobacco rating factors before the average is calculated across consumers with QHP selections.
Cross-state comparability: CMS states that data are directly comparable among states using HealthCare.gov. Comparisons involving State-based Marketplaces operating their own enrollment platforms require additional caution because definitions, reporting systems and premium-calculation practices can differ.
2026 OEP platform categories
FFM means Federally-facilitated Marketplace. SBE means a State-based Marketplace operating its own eligibility and enrollment platform. SBE-FP means a State-based Marketplace using the federal HealthCare.gov platform. The platform field reflects the classification applicable to the 2026 Open Enrollment dataset rather than a later 2026 platform change.
Oklahoma is classified as FFM in the 2026 Open Enrollment dataset. CMS lists Oklahoma as an SBE-FP effective May 1, 2026, after the Open Enrollment reporting period represented in this ranking.
Missing values and ties
Missing values: none among the 50 states and District of Columbia included in the 2026 state-level dataset. Illinois and Mississippi both have Avg_Prm of $816, so both share rank 11 and the next displayed rank is 13.
National average
CMS Table 5 reports a 2026 national average premium before APTC of $741 per person per month. This is a national consumer-level average, not the arithmetic mean of the 51 state and DC values. CMS Table 5 reports $741 for 2026; the preceding narrative appears to repeat the 2025 figure of $619.
What the metric does not measure
Avg_Prm is not a benchmark Silver premium, a standardized quote for a fixed-age consumer, a family premium, an insurer rate increase, a deductible, an out-of-pocket maximum or a measure of provider-network quality. It also does not represent the amount a subsidy-eligible consumer necessarily pays after APTC.
State subsidy limitation
Some State-based Marketplaces provide additional state premium subsidies. Those state subsidies are not reflected in these CMS premium measures, so the gross-premium ranking should not be treated as a direct ranking of household affordability.
Main ranking: average 2026 ACA Marketplace premium by state
Search all 51 jurisdictions, filter by 2026 OEP platform or status, change sort order, or limit the view to the Top 10 or Top 20.
Average monthly ACA Marketplace premium per person before APTC, 2026
| Rank | State / jurisdiction | Average premium | Region / Note |
|---|---|---|---|
| 1 | West Virginia | $1,314 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 2 | Wyoming | $1,217 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 3 | Vermont | $1,090 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 4 | Alaska | $1,043 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 5 | Connecticut | $1,030 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 6 | Maine | $913 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 7 | Delaware | $901 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 8 | New Mexico | $842 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 9 | Arkansas | $839 | SBE-FP; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 10 | Tennessee | $838 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 11 | Illinois | $816 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 11 | Mississippi | $816 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 13 | District of Columbia | $815 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 14 | New York | $812 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 15 | Florida | $806 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 16 | Nebraska | $800 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 17 | Kentucky | $797 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 18 | Wisconsin | $784 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 19 | Kansas | $779 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 20 | Hawaii | $778 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 21 | Georgia | $777 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 22 | Louisiana | $759 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 23 | North Carolina | $755 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 24 | Alabama | $743 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 25 | Pennsylvania | $742 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 26 | Oregon | $741 | SBE-FP; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 27 | Washington | $738 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 28 | California | $737 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 29 | New Jersey | $734 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 30 | Montana | $729 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 31 | Oklahoma | $727 | FFM during 2026 OEP; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; Oklahoma became SBE-FP effective May 1, 2026. |
| 32 | Missouri | $724 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 33 | Texas | $709 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 34 | Arizona | $688 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 35 | South Dakota | $684 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 36 | Colorado | $673 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 37 | Ohio | $665 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 38 | Nevada | $659 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 39 | Michigan | $657 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 40 | South Carolina | $655 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 41 | Rhode Island | $649 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 42 | Minnesota | $639 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 43 | Indiana | $623 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 44 | Iowa | $615 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 45 | Massachusetts | $594 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 46 | North Dakota | $591 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 47 | Virginia | $575 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 48 | Utah | $571 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 49 | New Hampshire | $553 | FFM; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026. |
| 50 | Maryland | $542 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
| 51 | Idaho | $509 | SBE; official_value; CMS 2026 OEP State-Level Public Use File; source year 2026; target year 2026; own-platform SBE comparability caveat applies. |
Source snapshot: CMS 2026 Marketplace Open Enrollment State-Level Public Use File. Platform labels describe the 2026 OEP dataset. CMS cautions that comparisons involving own-platform State-based Marketplaces may be affected by differences in definitions, reporting systems and calculation practices.
Insights from the 2026 premium ranking
Key Insight
Five states have average gross Marketplace premiums of at least $1,000 per person per month: West Virginia, Wyoming, Vermont, Alaska and Connecticut.
Notable Pattern
CMS reports a national consumer-level average of $741. Oregon's state Avg_Prm is also $741, with Pennsylvania at $742 and Washington at $738.
Regional/Source Concentration
All 51 premium values come from the CMS 2026 OEP state-level dataset. The highest-ranked states include FFM, SBE and SBE-FP jurisdictions rather than a single platform type.
Outlier
West Virginia leads at $1,314, which is $97 above Wyoming and $805 above Idaho, the lowest state value.
What this ranking means
The table compares gross monthly premiums associated with Marketplace QHP selections in each jurisdiction before federal APTC is applied.
It is not a direct affordability ranking. APTC can substantially change the amount eligible consumers pay, and some State-based Marketplaces provide additional state assistance that is not reflected in these CMS premium measures.
State averages also reflect the mix of consumers and plans selected. A benchmark premium for a specified age is more appropriate when the goal is a standardized plan-price comparison; CMS after-APTC measures are more appropriate when the question is consumer premium cost after federal assistance.
FAQ
What does “average ACA Marketplace premium” mean here?
It means CMS Avg_Prm: the average monthly premium per person before APTC among consumers with a 2026 Qualified Health Plan selection.
Which state has the highest average Marketplace premium in 2026?
West Virginia ranks first at $1,314 per person per month, followed by Wyoming at $1,217 and Vermont at $1,090.
Which state has the lowest average premium?
Idaho has the lowest state Avg_Prm in the 2026 CMS dataset at $509 per person per month.
Are these benchmark Silver premiums?
No. Benchmark premiums normally refer to the second-lowest-cost Silver plan used in premium tax credit calculations. This ranking uses CMS Avg_Prm across Marketplace QHP selections.
Are these the amounts consumers pay after subsidies?
No. The ranking uses gross premiums before APTC. CMS publishes separate measures for premiums after APTC.
Are all state values perfectly comparable?
No. CMS states that data are directly comparable among states using HealthCare.gov. Comparisons involving State-based Marketplaces operating their own enrollment platforms require caution because definitions, reporting systems and premium-calculation practices can differ.
Why is Oklahoma listed as FFM?
The platform field follows the 2026 Open Enrollment dataset. Oklahoma was classified as FFM for that reporting period and became an SBE-FP effective May 1, 2026.
Are these official published values?
Yes. Every premium value is classified as official_value because CMS directly publishes the 2026 Avg_Prm observation. No premiums in the ranking are modeled or projected.
Sources
CMS — 2026 Marketplace Open Enrollment Period Public Use Files
Primary source for the 2026 state-level Avg_Prm values used in the ranking.
CMS — 2026 Public Use Files Definitions
Official definitions for Avg_Prm, QHP plan selections, APTC and Marketplace terminology.
https://www.cms.gov/files/document/2026-public-use-files-definitions.pdf
CMS — 2026 Public Use Files FAQs
Official methodology for premium calculations and CMS guidance on comparability involving State-based Marketplaces.
https://www.cms.gov/files/document/2026-public-use-files-faqs.pdf
CMS — Health Insurance Exchanges 2026 Open Enrollment Report
National context and Table 5 reporting the 2026 national average premium before APTC of $741.
https://www.cms.gov/files/document/health-insurance-exchanges-2026-open-enrollment-report.pdf
CMS — State Marketplace Types
Official reference for Marketplace platform classifications and Oklahoma's SBE-FP effective date.
https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/state-marketplaces
