What does ACA health insurance actually cost in your county?
County-level marketplace premiums, metal-tier breakdowns, issuer competition and multi-year trends — straight from the official CMS Public Use Files, for all 2,055 US counties.
The tradeoff, in one line
Across 97,082 marketplace plans, the metal level you pick is a deductible-for-premium swap: a typical Gold plan costs about $218/mo more than a Bronze plan, but its deductible runs roughly $4,617 lower ($1,542 vs $6,159). Lower premiums almost always mean higher out-of-pocket exposure — the chart below shows exactly where each tier lands.
Premium vs deductible: where every ACA metal tier lands
Each bubble is a metal tier's national average across the CMS Marketplace Public Use Files — positioned by average monthly premium (age 40) and average annual deductible, sized by how many plans carry that tier. Bronze sits upper-left (lower premium, higher deductible); Gold and Platinum sit lower-right (richer benefits, higher premium). The lower-left is the elusive low-premium, low-deductible "best value" zone.
ACA metal tiers: premium vs deductible
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).
Explore the data
Every page is built live from the CMS Marketplace Public Use Files. Start with the view that matches your question.
Counties
Premiums, issuer counts and metal-tier averages for all 2,055 US counties.
Issuers
Compare all 183 marketplace insurers by footprint, plan count and average premium.
States
State-level premium and competition summaries across 30 states.
Rankings
Cheapest and costliest counties, deductible extremes and the most competitive markets.
Research
Data-driven analyses of the ACA marketplace, with every figure derived directly from the underlying CMS records. 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.
TrendsACA premium trends, 2022–2026
How marketplace premiums have moved across five plan years, by metal level and region.
MethodologyHow we work with CMS data
Sources, refresh cadence, transformation steps, and the limits of every plan-level metric we publish.