ACA Health Insurance Costs by County
Public-data reference. for PlainHealthPlan.
Free browsable county-level ACA premiums, 2022-2026 trends, issuer competition for 2,055 US counties.
Compare ACA health insurance premiums across 2,055 US counties. Browse plans by metal level, track premium trends, and find affordable coverage in your area.
Premium vs Deductible: where every ACA plan tier lands
Each dot represents a representative plan from the CMS Marketplace PUF, positioned by monthly base premium and annual deductible. Bronze plans cluster upper-left (low premium, high deductible — catastrophic protection). Platinum-style plans cluster lower-right (richer benefits, higher premium). Lower-left is the elusive "best value" zone.
National avg Silver plan premium as % of $800 ceiling — CMS Marketplace PUF (2026)
Source: CMS Marketplace PUF national averages (PY2026). The federal $9,450 self-only out-of-pocket-maximum ceiling for 2026 plans defines the upper bound.
Most Expensive Counties (Silver Avg)
| # | County | State | Silver Avg | Plans | Issuers |
|---|---|---|---|---|---|
| 1 | Monroe | Florida | $1,318/mo | 33 | 1 |
| 2 | Hamilton | Florida | $1,189/mo | 52 | 2 |
| 3 | Cabell | West Virginia | $981/mo | 37 | 2 |
| 4 | Mason | West Virginia | $981/mo | 37 | 2 |
| 5 | Putnam | West Virginia | $981/mo | 37 | 2 |
| 6 | Wayne | West Virginia | $981/mo | 37 | 2 |
| 7 | Jackson | West Virginia | $967/mo | 37 | 2 |
| 8 | Pleasants | West Virginia | $967/mo | 37 | 2 |
| 9 | Ritchie | West Virginia | $967/mo | 37 | 2 |
| 10 | Tyler | West Virginia | $967/mo | 37 | 2 |
Most Affordable Counties (Silver Avg)
| # | County | State | Silver Avg | Plans | Issuers |
|---|---|---|---|---|---|
| 1 | Belknap | New Hampshire | $395/mo | 46 | 4 |
| 2 | Hillsborough | New Hampshire | $395/mo | 46 | 4 |
| 3 | Merrimack | New Hampshire | $395/mo | 46 | 4 |
| 4 | Rockingham | New Hampshire | $395/mo | 46 | 4 |
| 5 | Strafford | New Hampshire | $395/mo | 46 | 4 |
| 6 | Carroll | New Hampshire | $412/mo | 39 | 3 |
| 7 | Cheshire | New Hampshire | $412/mo | 39 | 3 |
| 8 | Coos | New Hampshire | $412/mo | 39 | 3 |
| 9 | Grafton | New Hampshire | $412/mo | 39 | 3 |
| 10 | Sullivan | New Hampshire | $412/mo | 39 | 3 |
Browse by State
Frequently Asked Questions
What is PlainHealthPlan?
PlainHealthPlan is a free tool that lets you compare ACA (Affordable Care Act) health insurance premiums across every participating US county. We break down costs by metal level (Bronze, Silver, Gold, Platinum), show issuer competition, and track multi-year premium trends.
Where does the data come from?
All data comes from the CMS (Centers for Medicare & Medicaid Services) Health Insurance Marketplace Public Use Files (PUF). This is the official federal dataset of ACA marketplace plans, premiums, and benefits covering plan years 2022 through 2026.
What do the metal levels mean?
ACA plans are categorized by metal level based on how costs are shared between you and the insurer. Bronze plans have lower premiums but higher out-of-pocket costs. Silver plans are moderate and qualify for cost-sharing reductions. Gold plans have higher premiums but lower out-of-pocket costs. Platinum plans have the highest premiums but lowest cost-sharing.
What is the benchmark premium?
The benchmark premium is the second-lowest-cost Silver plan in a county. It is used to calculate premium tax credit (subsidy) amounts for eligible enrollees. A higher benchmark generally means larger subsidies are available.
Is this free to use?
Yes. PlainHealthPlan is completely free to use. No account required. We are supported by advertising.
Understanding ACA Insurance
Guides to help you navigate health insurance decisions using real county-level premium data.
Open Enrollment Checklist
Step-by-step checklist for ACA open enrollment — documents, income verification, and plan comparison.
Choosing a Metal Level
How Bronze, Silver, Gold, and Platinum plans actually differ — and which makes sense for your situation.
Understanding ACA Subsidies
How premium tax credits work, who qualifies, and how your county's benchmark affects your cost.
Disclaimer: PlainHealthPlan is for informational purposes only and does not provide financial or insurance advice. Premiums shown are for reference and may not reflect your actual cost, which depends on age, location, tobacco use, and subsidy eligibility. Always visit HealthCare.gov or your state marketplace for official enrollment and pricing. Data source: CMS Marketplace Public Use Files (PY2022-2026).
Related Guides
Editorial context for the plainhealthplan dataset — methodology, comparisons, and deep dives into the underlying records.
Research
Original analysis from our editorial team, every statistic derived from our own database. See all research.
Live county and issuer rankings
Browse live, DB-driven rankings of plans, issuers, and counties — refreshed when new CMS Plan Landscape files are released.
MethodologyHow we work with CMS data
Sources, refresh cadence, transformation steps, and the limits of every plan-level metric we publish.