Health insurance in Jefferson County, Alabama
4 insurers sell 54 marketplace plans here, and 10.4% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Who sells here, and how much choice that gives
4 insurers sell marketplace plans in Jefferson County, offering 54 plans between them, roughly 14 each. The number has not changed since the previous plan year.
How many people here have no coverage
10.4% of Jefferson County's 522,923 under-65 residents have no health coverage — 54,562 people. That is close to the Alabama rate of 10.0%, and puts Jefferson County in the middle half of the 1,817 counties on this site (971st).
Some of those 54,562 are in the Alabama coverage gap: under $15,960 a year, too little for a subsidy and no expanded Medicaid to fall back on.
How much the marketplace is used
61,991 Jefferson County residents selected a marketplace plan for 2026: 119 per thousand under-65 residents, 560th of 1,817. That is above the 78 per thousand typical of published counties. 7,517 of them — 12% — were new rather than renewing.
Jefferson County against Alabama
Jefferson County is the largest of the 8 Alabama counties we publish, by under-65 population. Its uninsured rate tracks the state almost exactly and with 4 insurers it is as well served as anywhere in Alabama. Marketplace use is close to the Alabama rate.
| Jefferson County | Alabama | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 10.4% | 10.0% | 9.9% |
| Insurers selling | 4 | 2–4 | 4 |
| Plans offered | 54 | — | 57 |
| Selections per 1,000 | 119 | 114 | 78 |
| New rather than renewing | 12% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Madison County | 344,068 | 8.3% | 4 | 52 |
| Mobile County | 325,164 | 9.8% | 3 | 43 |
| Baldwin County | 201,674 | 9.5% | 3 | 43 |
| Shelby County | 191,414 | 7.1% | 4 | 54 |
| Douglas County (Nebraska) | 503,402 | 8.8% | 5 | 81 |
Douglas County has 5 insurers against this county's 4 — a reminder that the county line, not the state line, is what decides your options.
Other Alabama counties · Where the subsidy stops · Enrollment dates