What marketplace health insurance costs
The national average applies to nobody. Price is set by five things, and one of them is the county you live in.
There is no single price for marketplace health insurance, and the national average you will find quoted is close to useless for deciding anything. What you pay is set by five things, and one of them is which county you live in.
That last one does most of the damage to averages. Across the 1,817 counties on this site, the number of insurers competing for your business ranges from 1 to 13, and the number of plans on offer from 14 to 215. Those are different markets with different prices, and they can sit in the same state.
Insurer and plan counts: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release. Rate-increase figure: insurer rate filings for 2027.
The five things that legally set your price
Under the Affordable Care Act an insurer may price a marketplace plan on five factors and no others. Health status is not among them, and neither is sex.
- Your age. Capped at a 3:1 ratio — a 64-year-old cannot be charged more than three times a 21-year-old for the same plan.
- Whether you use tobacco. Capped at 1.5:1, and some states ban the surcharge outright.
- Where you live. Not your state — your rating area, which is built from counties.
- How many people are on the plan.
- Which plan you choose. The metal tier, and the specific plan inside it.
Everything else — your medical history, a condition you already have, a claim you made last year — is off the table. More on each of the five.
What you pay is not what the plan costs
Most people who buy through the marketplace do not pay the sticker price. A premium tax credit covers the gap between what the government decides you can afford and what the benchmark plan in your area actually costs. For 2027 coverage, "what you can afford" tops out at 10.22% of your household income.
Two consequences worth understanding before you shop:
- Because the credit is pegged to a local benchmark plan, a more expensive county often means a larger credit, not a larger bill.
- Because the credit stops entirely above a fixed income line, one dollar of extra income can cost thousands. That is the subsidy cliff, and it is back in force for 2027.
How the credit is calculated, with the 2027 table.
Where the county data changes the answer
If you live somewhere with one insurer, comparison shopping is not really available to you and the benchmark plan is whatever that insurer decided to charge. If you live somewhere with eight, the benchmark is the product of real competition. Both situations are common.
Look up your state and county to see which one you are in before you start comparing plans.
The other pages in this section
- Premium tax credits — who qualifies and how the amount is worked out.
- The subsidy cliff — the income line where help stops completely.
- Bronze, silver, gold, platinum — what the tiers mean, and why silver is often the right answer even when it looks wrong.
- What affects your price — the five legal rating factors in detail.