Health insurance in St. Louis city, Missouri
6 insurers sell 68 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
6 insurers compete in St. Louis city with 68 plans between them, about 11 plans each. It gained 1 since the previous plan year, up from 5.
How many people here have no coverage
10.4% of St. Louis city's 220,460 under-65 residents have no health coverage — 23,005 people. That is close to the Missouri rate of 9.2%, and puts St. Louis city in the middle half of the 1,817 counties on this site (979th).
How much the marketplace is used
22,766 St. Louis city residents selected a marketplace plan for 2026: 103 per thousand under-65 residents, 747th of 1,817. That is above the 78 per thousand typical of published counties. 3,255 of them — 14% — were new rather than renewing.
St. Louis city against Missouri
St. Louis city is the 6th largest of the 12 Missouri counties we publish. Its uninsured rate runs 1.2 points higher than Missouri overall and with 6 insurers it is as well served as anywhere in Missouri. Marketplace use is about 1.4 times the Missouri rate.
| St. Louis city | Missouri | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 10.4% | 9.2% | 9.9% |
| Insurers selling | 6 | 2–6 | 4 |
| Plans offered | 68 | — | 57 |
| Selections per 1,000 | 103 | 74 | 78 |
| New rather than renewing | 14% | 13% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Clay County | 221,547 | 8.0% | 5 | 55 |
| Greene County | 247,489 | 9.9% | 4 | 48 |
| Jefferson County | 191,304 | 7.7% | 4 | 48 |
| Boone County | 155,950 | 7.6% | 4 | 48 |
| St. Louis County | 777,655 | 6.6% | 6 | 68 |
All of them have fewer insurers than this county's 6, which makes it the stronger market locally.
68 plans is a lot to work through. Start with network type, then the metal tiers. Other Missouri counties.