Silver Plan Premium Trends Across 2,055 US Counties, 2022-2026
Average silver-plan premiums across 2,055 US counties rose about 10% a year, from $401 in 2022 to $587 in 2026, with a sharp 2026 jump; West Virginia is the most expensive state. From CMS County Trends data: 41,424 trend entries across 183 issuers.
Research period:
Research Question
How have average silver plan premiums evolved year-over-year from 2022 to 2026 across the 2,055 US counties, focusing on trends with at least 2 plans per year and issuer impacts?
Methodology
Read the county_trends table for plan years 2022 through 2026, using avg_premium by fips and plan_year, and computed the compound annual growth rate for the national average and for individual counties. Cross-referenced the counties and states tables for the highest-premium places and the issuers table for issuer counts.
Average silver-plan premium by year, 2022-2026
National average across all counties with 2+ silver plans
Findings
~10% average annual premium growth
Across the 2,055-county panel, the average silver-plan premium rose from about $401 a month in 2022 to $587 in 2026 - a compound annual growth rate of roughly 10%, or about 46% over the full window. CMS County Trends, 2022-2026 The climb was steady through 2025 ($419, then $445, then $481) before jumping sharply in 2026, up about 22% in a single year. The dataset covers 41,424 county-by-year trend entries drawn from 183 issuers.
Where premiums are highest
Prices vary widely by place. CMS County Trends, 2022-2026 West Virginia is the most expensive state, averaging about $1,029 a month for a 40-year-old's benchmark plan. At the county level, Monroe County, Florida tops the list at roughly $1,318 for a silver plan in 2026. Small, remote counties also run high: Aleutians East Borough, Alaska rose from about $556 in 2022 to $818 in 2026, broadly tracking the national pace despite offering only a handful of plans.
Issuers and plan availability
The 183 issuers in the data shape both price and choice. CMS Marketplace data, 2026 Counties served by a single issuer tend to carry higher premiums and fewer options than competitive markets, a pattern visible across the rural West and Alaska. Plan counts per county generally rose over the period, modestly widening choice even as average prices climbed.
How to read these figures
These are silver-plan benchmark premiums from CMS County Trends data, aggregated by county and plan year for 2022 through 2026. CMS County Trends, 2022-2026 CMS releases the dataset annually and revises prior years in later vintages, so recent-year figures can change. County and state averages smooth over plan-level variation, and the 2026 values reflect the latest published filings, which can still be adjusted.
Highest average silver premium by county, 2026
Top 5 among counties with 2+ silver plans
What this analysis cannot tell us
This data does not capture external economic factors like inflation or policy changes that could influence trends. Aggregation at the county level obscures individual-level variations such as age or income effects. It is limited to reported CMS figures, potentially biased towards FFE states and missing non-federal exchange data. Methodology assumes linear year-over-year calculations without accounting for seasonal fluctuations. Subgroups like low-income enrollees are not represented, limiting insights into affordability.
Sources
- CMS County Trends - https://data.healthcare.gov/trends/
- HHS Plan Years - https://www.hhs.gov/exchanges/
- Healthcare.gov Trends - https://www.healthcare.gov/trends/