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ACA Marketplace premiums jumped 20% nationally for 2026, but state-level increases range from –3% to 67%. MoneyGeek's analysis of all 50 states plus Washington, D.C., shows the difference stems from three policy choices: Medicaid expansion, reinsurance programs and state-run marketplaces. States with these protections saw measurably lower premium growth.
The 2026 rate filings show continued divergence between states that actively manage their markets and those that rely on the federal platform.
Premium changes for 2026 vary widely across the country, as shown in the map below, with color intensity reflecting the size of each state's increase. State-based marketplaces have generally contained rate hikes better than federal marketplaces. Hover over any state to see its specific rate change, marketplace type, Medicaid expansion status and reinsurance programs.
Population-weighted gross premiums rose approximately 20% from 2025 to 2026, according to MoneyGeek's analysis of rate filings for Silver-tier benchmark plans from all 50 states and Washington, D.C. Population-weighting means each state's average was weighted by its 2024 Census population to better reflect the national impact of rate changes.
These findings coincide with the start of 2026 open enrollment and come as Congress debates whether to extend enhanced premium tax credits set to expire at the end of 2025.
The national figure masks substantial state-to-state variation. Ten states saw health insurance premium increases exceeding 30%, while eight held increases below 10%. State policy choices (including marketplace structure, reinsurance programs and Medicaid expansion) correlate with measurably different outcomes. The findings arrive as millions of Americans shop for 2026 coverage during open enrollment.
Eleven states saw increases exceeding 30%.
Arkansas | +66.7% | $494 → $823 | FFM | Yes | Yes* |
New Mexico | +50.7% | $608 → $917 | SBM | Yes | Yes |
Tennessee | +38.4% | $556 → $770 | FFM | No | No |
Mississippi | +37.2% | $541 → $743 | FFM | No | No |
Texas | +34.2% | $586 → $787 | FFM | No | No |
Florida | +32.7% | $647 → $859 | FFM | No | No |
Delaware | +31.3% | $578 → $759 | FFM | Yes | Yes |
Arizona | +31.2% | $528 → $692 | FFM | Yes | No |
Georgia | +30.8% | $658 → $861 | SBM | Yes | No |
New Hampshire | +30.8% | $368 → $482 | FFM | Yes | Yes |
Nevada | +30.4% | $533 → $696 | SBM | Yes | Yes |
Premiums shown are gross benchmark Silver plan averages before subsidies for a 40-year-old.
*Arkansas operates a limited reinsurance program that didn't prevent steep increases. It leads the nation with a 67% increase, adding $329 monthly ($3,951 annually) for unsubsidized enrollees.
Four of the top 11 states haven't expanded Medicaid. Florida and Texas, two of the nation's largest states, both exceed 30% increases.
At the other end of the spectrum, five states kept premium increases below 6%, with three operating state-based marketplaces.
Alaska | −2.8% | $1,070 → $1,040 | FFM | Yes | Yes |
New York* | +1.8% | $1,134 → $1,154 | SBM | Yes | No |
Washington | +5.5% | $528 → $557 | SBM | Yes | Yes |
Vermont* | +5.7% | $1,157 → $1,223 | SBM | Yes | No |
South Dakota | +5.8% | $640 → $677 | FFM | Yes | No |
Premiums shown are gross benchmark Silver plan averages before subsidies for a 40-year-old.
*Community-rated market
Alaska is the only state where premiums fell, dropping nearly 3% due to its reinsurance program.
But low percentage increases don't necessarily mean low premiums. Vermont's 6% increase still results in a $1,223 monthly premium, nearly 50% higher than Arkansas's $823, despite Arkansas's 67% jump. Community-rated states like Vermont and New York start with higher baseline costs because premiums don't vary by age, spreading risk more evenly across all enrollees.
The South bore the brunt of 2026 premium increases.
South | $593 | $766 | +29.2% |
Midwest | $547 | $654 | +19.5% |
West | $588 | $682 | +16.1% |
Northeast | $790 | $864 | +9.3% |
Regional averages are population-weighted using 2024 Census data.
Southern states averaged 29% premium growth, more than triple the Northeast's 9%. Southern states are less likely to have expanded Medicaid, run their own marketplaces or operate reinsurance programs.
Find your state's 2026 premium change and policy context in the table below. States are sorted by percentage increase, with the highest jumps first.
Arkansas* | $494 | $823 | +66.7% | FFM | Yes | Yes* |
New Mexico | $608 | $917 | +50.7% | SBM | Yes | Yes |
Tennessee | $556 | $770 | +38.4% | FFM | No | No |
Mississippi | $541 | $743 | +37.2% | FFM | No | No |
Texas | $586 | $787 | +34.2% | FFM | No | No |
Florida | $647 | $859 | +32.7% | FFM | No | No |
Delaware | $578 | $759 | +31.3% | FFM | Yes | Yes |
Arizona | $528 | $692 | +31.2% | FFM | Yes | No |
Georgia | $658 | $861 | +30.8% | SBM | Yes | No |
New Hampshire | $368 | $482 | +30.8% | FFM | Yes | Yes |
Nevada | $533 | $696 | +30.4% | SBM | Yes | Yes |
Connecticut | $665 | $859 | +29.3% | SBM | Yes | No |
Michigan | $529 | $684 | +29.2% | FFM | Yes | No |
Indiana | $438 | $564 | +28.8% | FFM | Yes | No |
Nebraska | $725 | $918 | +26.6% | FFM | Yes | No |
Wyoming | $884 | $1,114 | +26.0% | FFM | No | No |
Minnesota | $452 | $569 | +25.9% | SBM | Yes | Yes |
Maine | $619 | $767 | +23.9% | SBM | Yes | Yes |
Louisiana | $628 | $778 | +23.8% | FFM | Yes | No |
Virginia | $523 | $642 | +22.9% | SBM | Yes | Yes |
Alabama | $575 | $703 | +22.3% | FFM | No | No |
Kansas | $623 | $760 | +22.0% | FFM | No | No |
Colorado | $508 | $619 | +21.8% | SBM | Yes | Yes |
Oklahoma | $583 | $709 | +21.5% | FFM | Yes | No |
Montana | $616 | $748 | +21.5% | FFM | Yes | Yes |
North Carolina | $639 | $775 | +21.3% | FFM | Yes | No |
Rhode Island | $477 | $577 | +21.0% | SBM | Yes | Yes |
Utah | $645 | $780 | +20.9% | FFM | Yes | No |
Iowa | $493 | $594 | +20.6% | FFM | Yes | No |
South Carolina | $538 | $648 | +20.5% | FFM | No | No |
Missouri | $614 | $728 | +18.4% | FFM | Yes | No |
Wisconsin** | $603 | $714 | +18.5% | FFM | No** | Yes |
Ohio | $533 | $630 | +18.1% | FFM | Yes | No |
Kentucky | $556 | $653 | +17.5% | SBM | Yes | Yes |
Pennsylvania | $605 | $710 | +17.5% | SBM | Yes | Yes |
Maryland | $412 | $477 | +15.8% | SBM | Yes | Yes |
West Virginia | $952 | $1,089 | +14.4% | FFM | Yes | No |
Oregon | $621 | $706 | +13.7% | SBM | Yes | Yes |
New Jersey | $584 | $659 | +12.9% | SBM | Yes | Yes |
California | $611 | $685 | +12.2% | SBM | Yes | Yes |
Idaho | $487 | $542 | +11.4% | SBM | Yes | Yes |
Massachusetts | $647 | $718 | +11.1% | SBM | Yes | No |
Hawaii | $527 | $583 | +10.6% | FFM | Yes | Yes |
North Dakota | $571 | $627 | +9.7% | FFM | Yes | Yes |
Washington, D.C. | $573 | $621 | +8.4% | SBM | Yes | No |
Illinois | $579 | $624 | +7.8% | FFM | Yes | No |
South Dakota | $640 | $677 | +5.8% | FFM | Yes | No |
Vermont*** | $1,157 | $1,223 | +5.7% | SBM | Yes | No |
Washington | $528 | $557 | +5.5% | SBM | Yes | Yes |
New York*** | $1,134 | $1,154 | +1.8% | SBM | Yes | No |
Alaska | $1,070 | $1,040 | −2.8% | FFM | Yes | Yes |
*Arkansas operates a limited reinsurance program approved in 2021. The modest design didn't prevent a 67% increase.
**Wisconsin expanded Medicaid to 100% of the federal poverty level only (partial expansion).
***Community-rated states where premiums don't vary by age.
MoneyGeek's statistical analysis shows consistent associations between state policy interventions and lower premium growth.
These associations are correlational, not causal, reflecting multiple market factors including insurer competition, provider costs and population health. But the direction and consistency of effects across policy dimensions suggest state interventions can moderate premium volatility.
States combining all three protections (Medicaid expansion, reinsurance and a state-run marketplace) reported the most stable premiums nationwide. Together, these policies reduced average increases to the low-teens range.
Nine states haven't expanded Medicaid: Alabama, Florida, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin (partial expansion) and Wyoming. Eight of these nine saw above-average premium growth.
Roughly 92% of ACA enrollees receive subsidies that reduce out-of-pocket costs. But gross rate changes affect federal budget costs and the approximately 8% of enrollees earning too much to qualify for assistance.
Enhanced federal subsidies are set to expire on December 31, 2025. The Congressional Budget Office estimates the number of uninsured people will increase by 3.8 million on average each year from 2026 to 2034 without a permanent extension. Unsubsidized consumers (about 2.4 million nationally, often self-employed or early retirees earning just above subsidy limits) bear the full impact of gross premium increases.
Example: A 40-year-old earning $65,000 annually
*Illustrative example based on federal ACA subsidy formulas and 2026 benchmark premiums.
States have tools to moderate growth. The 22 states with reinsurance programs saw 4 percentage points lower increases on average. States can also transition to state-based marketplaces for greater regulatory control or expand Medicaid to improve risk pools.
Federal policymakers face decisions on subsidy extensions while states continue to show that active market management correlates with greater premium stability.
MoneyGeek analyzed Affordable Care Act Marketplace premiums for 2025 and 2026 using official rate filings from all 50 states and Washington, D.C. We focused on individual-market Silver-tier plans for a 40-year-old adult, the federal benchmark for comparing premiums across states.
Data Sources
Rates for Federally Facilitated Marketplace (FFM) states came from the Centers for Medicare & Medicaid Services (CMS) QHP Landscape and Rate Public Use Files. Data for State-Based Marketplaces (SBMs) came from state marketplace filings or, where unavailable, were collected directly by MoneyGeek. Marketplace classifications, Medicaid expansion status and reinsurance program designations were verified through CMS and Kaiser Family Foundation databases.
Calculation Method
For each state, we calculated the average monthly premium for Silver plans available to a 40-year-old. Premiums were cleaned, converted to numeric format and averaged across all rating areas within each state using a simple (unweighted) mean. This approach treats all plans equally, regardless of enrollment size or region, consistent with federal benchmarking conventions.
Premiums reflect the average of all Silver-tier plans, not just the second-lowest-cost (benchmark) Silver plan used in federal subsidy calculations. This approach provides a broader view of market pricing trends and captures the full range of options consumers face when shopping for coverage.
Catastrophic, child-only and small-business (SHOP) plans were excluded.
In community-rated states (New York, Vermont and Washington, D.C.), where premiums don't vary by age, the statewide individual-market Silver rate was used and flagged accordingly. Community-rated premiums shown in tables reflect statewide rates that do not vary by age.
Statistical Analysis
We used Welch's t-tests for policy comparisons between groups with unequal variances. Effect sizes were calculated using Cohen's d. Correlations used Pearson's r. Given small sample sizes in some policy groups (particularly non-expansion states, n=9), results emphasize effect sizes alongside statistical significance.
Validation and Scope
All averages were cross-checked against CMS and Kaiser Family Foundation benchmarks and aligned within a ±2% margin. 2026 data reflect rates filed and approved as of October 2025.
Limitations
Premiums represent gross (pre-subsidy) rates. Roughly 92% of Marketplace enrollees receive federal tax credits that lower actual out-of-pocket costs. Results describe broad pricing patterns and policy correlations (such as the effects of reinsurance and Medicaid expansion) but don't establish causation.
About Nathan Paulus
Nathan Paulus is the Head of Content Marketing at MoneyGeek, with nearly 10 years of experience researching and creating content related to personal finance and financial literacy.
Paulus has a bachelor's degree in English from the University of St. Thomas, Houston. He enjoys helping people from all walks of life build stronger financial foundations.
