States with the Highest Average Deductibles
All states ranked by highest average plan deductible, where out-of-pocket costs before coverage are highest.
What This Ranking Tells Us
High average deductibles can indicate several market dynamics: dominance of Bronze and Catastrophic plan enrollment, limited Silver plan CSR availability, or overall higher healthcare costs that push plan designs toward higher cost-sharing. In these states, consumers face more financial exposure before their insurance begins covering costs. Health Savings Accounts (HSAs) paired with high-deductible plans can help offset this burden through tax-advantaged savings.
What the Data Reveals Across 30 States
This ranking covers 30 states and jurisdictions in the ACA marketplace. Michigan tops the list at $5,919, while Texas sits at the opposite end with $4,481. The median value across all ranked states is $5,045, giving a rough sense of where a typical state lands relative to the extremes. The spread between top and bottom - $1,438 - 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 deductible
All states ranked by highest average plan deductible, where out-of-pocket costs before coverage are highest.
States with the Highest Average Deductibles
| # | State | Avg Deductible |
|---|---|---|
| 1 | Michigan MI | $5,919 |
| 2 | Arkansas AR | $5,607 |
| 3 | Arizona AZ | $5,550 |
| 4 | Oregon OR | $5,472 |
| 5 | South Dakota SD | $5,443 |
| 6 | Indiana IN | $5,418 |
| 7 | Montana MT | $5,388 |
| 8 | Tennessee TN | $5,353 |
| 9 | Wisconsin WI | $5,293 |
| 10 | West Virginia WV | $5,283 |
| 11 | South Carolina SC | $5,169 |
| 12 | North Dakota ND | $5,161 |
| 13 | Missouri MO | $5,056 |
| 14 | Ohio OH | $5,047 |
| 15 | Iowa IA | $5,045 |
| 16 | Alabama AL | $5,045 |
| 17 | Utah UT | $5,025 |
| 18 | Louisiana LA | $4,974 |
| 19 | Florida FL | $4,963 |
| 20 | New Hampshire NH | $4,944 |
| 21 | Mississippi MS | $4,911 |
| 22 | Kansas KS | $4,878 |
| 23 | Hawaii HI | $4,877 |
| 24 | North Carolina NC | $4,840 |
| 25 | Nebraska NE | $4,829 |
| 26 | Delaware DE | $4,819 |
| 27 | Oklahoma OK | $4,765 |
| 28 | Wyoming WY | $4,578 |
| 29 | Alaska AK | $4,502 |
| 30 | Texas TX | $4,481 |
Source: CMS ACA Marketplace Public Use Files, Plan Year 2026.
Frequently Asked Questions
Why do some states have much higher deductibles?
Higher average deductibles often reflect enrollment patterns favoring Bronze plans (which have the lowest premiums but highest deductibles), limited availability of Cost-Sharing Reduction Silver plans, and underlying healthcare costs that force insurers to design plans with more cost-sharing to keep premiums manageable.
Can I reduce my deductible?
Yes. Choosing a higher metal level (Silver, Gold, Platinum) gives you a lower deductible in exchange for higher monthly premiums. If you qualify for Cost-Sharing Reductions (income 100-250% FPL), Silver plans offer dramatically reduced deductibles. Additionally, preventive care services are always covered at no cost regardless of whether you have met your deductible.
Explore More Rankings
Read our methodology - how this data is sourced, computed, and verified.