CMS Marketplace ranking · Avg Premium
States with the Cheapest Health Plan Premiums
All states ranked by lowest average monthly premium, the most affordable health insurance markets.
Data updated 2026-08-30
- $391
- #1 New Hampshire
- 30
- States ranked
- $568
- Median value
- $844
- Last: West Virginia
What This Ranking Tells Us
States with the lowest average premiums benefit from competitive insurer markets, lower underlying healthcare costs, and efficient provider networks. Many of the most affordable states have strong issuer competition with 5 or more companies offering plans. Lower premiums do not necessarily mean less coverage, all ACA plans must cover the same 10 essential health benefits regardless of price. For budget-conscious consumers, these states offer the most value in the marketplace.
What the Data Reveals Across 30 States
This ranking covers 30 states and jurisdictions in the ACA marketplace. New Hampshire tops the list at $391, while West Virginia sits at the opposite end with $844. The median value across all ranked states is $568, giving a rough sense of where a typical state lands relative to the extremes. The spread between top and bottom - $453 - illustrates how unevenly this particular metric is distributed across the country.
Rankings of this kind are shaped by a mix of structural factors: issuer competition, hospital and physician pricing, whether a state expanded Medicaid (which affects who enrolls in marketplace plans vs Medicaid), state-specific benefit mandates, and the age and health profile of each state's enrollment pool. Two states with similar demographics can still post very different numbers because of marketplace design choices and regulatory posture. The figures shown here are base rates, most enrollees pay less after Advance Premium Tax Credits are applied, with subsidy size keyed to each county's benchmark (second-lowest Silver) premium.
Use this ranking as a starting point for state-level comparison, not as a personalized recommendation. Your actual premium, deductible, and out-of-pocket exposure depend on age, household income, tobacco use, county of residence, and the specific plan you choose. Click any state to drill into county-level data, and always verify final pricing, provider networks, and subsidy eligibility at HealthCare.gov before enrolling. This page is informational only and is not insurance, medical, or tax advice. Source: CMS ACA Marketplace Public Use Files, Plan Year 2026.
Top 12 states - avg premium
All states ranked by lowest average monthly premium, the most affordable health insurance markets.
The Bar to Make This List
Where the top-12 cutoff sits among all 30 ranked states
Every ranked state's avg premium, bucketed by $106
$548 12th of 30 higher than 11 of 30 states
all 30 ranked states, bucketed by value
Each bar is a $106-wide band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count and share, and where it sits relative to this entry.
Source CMS ACA Marketplace Public Use Files, Plan Year 2026
| # | State | Avg Premium |
|---|---|---|
| 1 | New HampshireNH | $391 |
| 2 | IowaIA | $458 |
| 3 | HawaiiHI | $463 |
| 4 | North DakotaND | $499 |
| 5 | South CarolinaSC | $500 |
| 6 | IndianaIN | $510 |
| 7 | OhioOH | $520 |
| 8 | MichiganMI | $525 |
| 9 | OregonOR | $529 |
| 10 | AlabamaAL | $539 |
| 11 | South DakotaSD | $546 |
| 12 | MissouriMO | $548 |
| 13 | WisconsinWI | $551 |
| 14 | MontanaMT | $556 |
| 15 | ArizonaAZ | $562 |
| 16 | OklahomaOK | $568 |
| 17 | ArkansasAR | $570 |
| 18 | TexasTX | $575 |
| 19 | TennesseeTN | $583 |
| 20 | DelawareDE | $586 |
| 21 | KansasKS | $602 |
| 22 | LouisianaLA | $608 |
| 23 | North CarolinaNC | $609 |
| 24 | MississippiMS | $641 |
| 25 | AlaskaAK | $720 |
| 26 | FloridaFL | $728 |
| 27 | NebraskaNE | $729 |
| 28 | UtahUT | $791 |
| 29 | WyomingWY | $841 |
| 30 | West VirginiaWV | $844 |
Source: CMS ACA Marketplace Public Use Files, Plan Year 2026.
Frequently Asked Questions
Does a cheap premium mean less coverage?
No. All ACA marketplace plans must cover the same 10 essential health benefits including hospitalization, prescription drugs, maternity care, mental health, and preventive services. Lower premiums in some states reflect lower underlying healthcare costs and more competition, not fewer benefits. However, cheaper plans within a state (Bronze vs. Gold) do have different cost-sharing structures.
What keeps premiums low in these states?
Key factors include strong insurer competition (many companies bidding for enrollees), lower hospital and physician costs, efficient provider networks, state regulatory environments that promote competition, and healthier enrollment pools. States with Medicaid expansion tend to have lower marketplace premiums because sicker, lower-income individuals are covered by Medicaid instead.
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Read our methodology - how this data is sourced, computed, and verified.