What state has the cheapest ACA plans?
New Hampshire has the cheapest average Affordable Care Act (ACA) marketplace plans in the United States, with a monthly benchmark premium averaging $401 for a 40-year-old.
Cheapest States for ACA Plans
Based on data from KFF tracking average monthly benchmark (second-lowest-cost silver tier) premiums for a 40-year-old, the states with the lowest average costs are:
- New Hampshire: $401 per month
- Maryland: $414 per month
- Minnesota: $448 per month
- Virginia: $455 per month
- Indiana: $474 per month
State Comparison Table
| State | Average Lowest-Cost Bronze | Average Lowest-Cost Silver | Average Benchmark Premium |
|---|---|---|---|
| New Hampshire | $283 – $394 | $394 – $394 | $401 |
| Maryland | $365 – $414 | $403 – $414 | $414 |
| Minnesota | $384 | $437 – $448 | $448 |
| Virginia | Not ranked in top bronze | $455 | $455 |
| Indiana | $405 | $473 – $474 | $474 |
Important Factors to Keep in Mind
- Subsidies change your actual cost: These averages are base premiums before federal tax credits or state-specific subsidies are applied. Most enrollees qualify for financial help that significantly lowers their monthly out-of-pocket price.
- Location matters most: ACA rates are not based on your medical history or pre-existing conditions, but they vary heavily by state, county, and local insurance market competition.
Which states have the lowest ACA premiums?
New Hampshire, Maryland, and Minnesota have the lowest average Affordable Care Act (ACA) benchmark premiums in the country.
According to data from KFF for 2026 coverage, average monthly benchmark premiums (the second-lowest cost silver plan for a 40-year-old) vary significantly across the lowest-cost states:
- New Hampshire: $401 per month
- Maryland: $414 per month
- Minnesota: $448 per month
- Virginia: $455 per month
- Indiana: $474 per month
These rates sit well below the U.S. national average of $625 per month. For broader context on nationwide pricing trends, you can review the World Population Review.
Which US state has the most affordable healthcare?
Hawaii is widely ranked as the U.S. state with the most affordable healthcare.
According to reports from US News, Hawaii takes the top spot for healthcare affordability due to low average insurance costs and fewer people skipping doctor visits because of price.
Why Hawaii is Affordable
- Prepaid Health Care Act: This state law requires most employers to provide health insurance to their workers.
- Low Premiums: A premium (the regular monthly payment to keep your insurance active) is very low in Hawaii compared to the rest of the country.
- Fewer Cost Barriers: Residents are less likely to delay seeing a doctor due to high bills.
Other Affordable States
Other states also score well for low costs and high affordability in national studies, such as the Commonwealth Fund health system report:
- Michigan: Ranks very high for low average insurance costs and marketplace prices.
- Iowa: Scores near the top for low out-of-pocket medical spending and overall cost of living.
- North Dakota: Offers low relative health care costs and strong affordability scores for residents.
What states get the most ACA subsidies?
States receive the most Affordable Care Act (ACA) subsidies in total overall funding through high enrollment in large states like Florida and Texas, while states like West Virginia and Alaska provide the highest average subsidy amount per individual person.
Highest Total Subsidy Volume (Overall Funding)
States with the highest total population and largest marketplace enrollment receive the largest aggregate amount of federal tax credits.
- Florida: Leads the nation with millions of enrollees, capturing billions in total assistance.
- Texas: Ranks near the top for total enrollment growth and aggregate federal support.
- Georgia and North Carolina: Also see massive total subsidy totals due to high numbers of people signing up.
- You can explore aggregate data via the KFF State Indicator.
Highest Average Subsidy Per Person
Some states have very high benchmark insurance costs, meaning the government pays a much larger average monthly subsidy (tax credit) for each person enrolled. According to studies from SmartAsset and data tracked by Becker's Payer Issues, the top states for average monthly subsidy per enrollee are:
- West Virginia: Over $1,030 to $1,060 per month per person.
- Alaska: Around $865 to $880 per month per person.
- Wyoming: Around $860 to $870 per month per person.
- Vermont: Around $845 per month per person.
- Connecticut: Around $605 to $760 per month per person.
What is the best state to live in if you're on Medicare?
Vermont, Utah, and Minnesota are consistently ranked as the best states for Medicare performance, offering superior access to care, lower out-of-pocket costs, and higher quality health outcomes.
Top-Performing States
- Vermont: Ranks at the top nationwide for Medicare metrics, featuring minimal cost barriers, high rates of enrollees finding regular providers, and excellent care quality.
- Utah: Scores high for low per-person program spending, strong local health infrastructure, and fewer restrictions on specialty care.
- Minnesota: Offers exceptional senior care services, strong preventive care management, and access to elite medical institutions like the Mayo Clinic.
- Rhode Island: Frequently leads individual indexes specifically for high Medicare Quality Rankings and high percentages of top-rated plans.
What Makes a State Good for Medicare
- Fewer Prior Authorizations: High-performing states often have Medicare Advantage plans with lower rates of restrictive prior authorization rules for specialist or preventive visits.
- Affordability: Better plan options reduce out-of-pocket spending on prescription drugs and coinsurance.
- Provider Access: A strong foundational state healthcare system makes it much easier to find a primary care doctor who accepts Medicare.
Can’t Afford Your ACA Plan? 2026 FIXES & CHEAPER OPTIONS!
Which states don't have Obamacare?
Every U.S. state has access to the Affordable Care Act (Obamacare), meaning no state completely lacks Obamacare.
As noted by the majority consensus on Quora, every state is covered by the federal health law and provides a health insurance marketplace, either through the federal website (HealthCare.gov) or via a state-run exchange.
States That Did Not Expand Medicaid
People sometimes confuse states "without Obamacare" with the 10 states that chose not to adopt the ACA’s Medicaid expansion. These states have an Obamacare marketplace, but they did not expand traditional Medicaid eligibility to low-income adults up to 138% of the federal poverty level:
- Alabama
- Florida
- Georgia
- Kansas
- Mississippi
- South Carolina
- Tennessee
- Texas
- Wisconsin
- Wyoming
How much is Obamacare per month in 2026?
In 2026, the average cost of an Obamacare (ACA) health insurance plan is $178 per month after tax subsidies, or $741 per month before subsidies are applied.
Costs for 2026 jumped significantly—with net consumer premiums rising by an average of 58%—due to the expiration of the federal pandemic-era enhanced premium tax credits.
What you will actually pay relies heavily on whether you qualify for subsidies based on your income:
💳 Average Cost Breakdown
- With Subsidies (Net Premium): The average subsidized enrollee pays $178 per month across all plans. If you choose the absolute lowest-cost plan available in your market, the average price drops to roughly $50 per month.
- Without Subsidies (Sticker Price): If your income is too high to qualify for financial aid, the average national premium is $741 per month.
📊 Average Costs by "Metal Tier" (Before Subsidies)
If you do not qualify for premium tax credits, your base cost is highly dependent on the level of coverage you select:
- Bronze Plans: Average $658 per month (Lower premiums, but higher out-of-pocket deductibles averaging close to $7,500).
- Silver Plans (Benchmark): Average $625 to $825 per month (The standard mid-tier baseline used to calculate government assistance).
- Gold Plans: Average $781 per month (Higher monthly premiums, but lowest out-of-pocket costs when receiving medical care).
🔍 Key Factors That Change Your Price
Your final monthly invoice is personal and will vary widely based on:
- Your Income: Subsidies operate on a sliding scale. In 2026, the "subsidy cliff" returned, meaning households earning more than 400% of the Federal Poverty Level (FPL)—such as individuals making over $62,600—generally no longer qualify for financial assistance.
- Your Age: Insurers are legally permitted to charge older adults up to three times more than younger enrollees for the exact same coverage.
- Your Location: Average benchmark premiums fluctuate severely by geographic region, ranging from a low average of $401 per month in New Hampshire to a high average of $1,299 per month in Vermont.
To calculate your exact localized pricing and see if you qualify for a premium tax credit, use the KFF Health Insurance Marketplace Calculator or log into HealthCare.gov.
What state is ranked #1 in health care?
Hawaii ranks #1 in overall healthcare according to the U.S. News & World Report rankings, while other major studies place New Hampshire or Massachusetts at the top depending on their specific criteria.
Top Rankings by Study
Different organizations use unique metrics like cost, access, or public health outcomes, leading to different top spots:
- U.S. News & World Report: Hawaii ranks #1 overall, excelling in healthcare quality and public health outcomes.
- WalletHub: New Hampshire ranks #1, scoring highest for healthcare outcomes and low costs.
- The Commonwealth Fund: Massachusetts ranks #1 for overall health system performance, access, and affordability.
What happens if you can't afford healthcare in America?
If you cannot afford healthcare in America, you risk delaying necessary medical treatment, accumulating massive medical debt, or facing severe health declines.
Emergency Care
- Emergency rooms must stabilize you during a life-threatening crisis under federal law (EMTALA), regardless of your ability to pay.
- Full treatment for underlying or chronic conditions is not required in emergency rooms once the immediate danger passes.
Routine and Preventive Care
- Delayed treatment is common, leading many to skip doctor visits, preventive screenings, or necessary prescription drugs.
- Worsened health outcomes often result from untreated chronic illnesses or advanced diseases caught too late.
Financial and Legal Consequences
- Medical debt affects millions of uninsured and underinsured Americans, frequently resulting in collections, damaged credit scores, or personal bankruptcy.
- No tax penalty exists federally for failing to carry health insurance, as the individual mandate penalty ended.
Available Safety Nets
- Community health centers and Federally Qualified Health Centers offer primary care on an income-based sliding scale.
- Charity care and financial assistance policies are provided by many non-profit hospitals to reduce or erase bills for low-income patients.
- Government programs like Medicaid provide free or low-cost coverage for qualifying low-income individuals.
What percent of US citizens use ACA?
About 6.8% of the U.S. population (roughly 23.1 million people) is enrolled in Affordable Care Act (ACA) marketplace plans.
ACA Marketplace Enrollment Details
- Total Enrollment: Around 23.1 million individuals are signed up for qualified health plans through ACA exchanges.
- Population Share: This represents approximately 6.8% of the U.S. population.
- Subsidies: About 86.7% of those enrolled receive financial assistance via Advance Premium Tax Credits or cost-sharing reductions, accounting for roughly 5.9% of the total U.S. population.
- Broader Impact: When including ACA-driven Medicaid expansions, tens of millions more Americans receive coverage through provisions established by the law, though marketplace-specific enrollment sits below 7%.