Guide
Why the same coverage costs more in some states
Cross a state line and an almost-identical plan can cost hundreds more or less a month. It isn't random — five local forces set the price. The 2026 national benchmark is about$625/mo, and states spread widely around it.
1.How many insurers compete
The single biggest lever. In a rating area with several insurers fighting for members, benchmark premiums tend to fall. In a county with one or two, prices climb. Competition is local — it can differ across counties in the same state.
2.What local care costs
Premiums reflect what hospitals, doctors, and drugs actually cost in your area. High local provider prices — common in some rural areas with a single dominant hospital system — push premiums up regardless of competition.
3.Who's in the risk pool
Premiums are set for the whole pool of people who enroll. A younger, healthier local pool costs less to cover; an older or sicker one costs more, and that shows up in everyone's price.
4.Whether the state runs reinsurance
Several states operate reinsurance programs that reimburse insurers for their most expensive claims. That blunts premium spikes, and states with these programs often show noticeably lower benchmarks.
5.Whether the state expanded Medicaid
In states that expanded Medicaid, more lower-income adults are covered outside the marketplace, which shapes who is left in the marketplace risk pool. It's one reason expansion and non-expansion states can price differently.
See where your state lands
The register shows every state's sourced 2026 benchmark record and where it sits against the published national benchmark—without presenting the average as your quote.
Common questions
Why is my premium so much higher than a friend's in another state?
Health plans are priced locally, in rating areas, so two people with the same age and income can pay very different premiums. The biggest drivers are how many insurers compete where you live and what local hospitals and doctors charge. The national benchmark for 2026 is about $625/mo, but state benchmarks range widely around it. Source: KFF, Marketplace Average Monthly Benchmark Premiums, 2026.
Can I buy a cheaper state's plan if I don't live there?
No. You're rated on your home address, not where you work or where a cheaper plan is sold. If you move, that's a qualifying event that lets you switch to your new state's plans. Source: HealthCare.gov.
Sources: KFF, Marketplace Average Monthly Benchmark Premiums, 2026; HealthCare.gov; KFF on rating areas, reinsurance, and Medicaid expansion. Per-state figures are on each state page. General information, not financial advice. Published February 2026 · Last reviewed: 2026.