Health insurance in Ohio
Insurers per county in Ohio run from 3 to 9. That is not one market, and the state average describes none of it.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release. Figures cover the under-65 population.
Where you enroll
Ohio uses the federally facilitated marketplace, so you enroll at HealthCare.gov on the federal calendar — the dates are here.
Medicaid covers the bottom of the range in Ohio
Ohio expanded Medicaid, so there is no coverage gap here: adults under 138% of the poverty guideline — about $22,025 for one person — go to Medicaid rather than falling between it and the subsidy.
760,419 under-65 Ohio residents are uninsured all the same, 8.1% of them — 30th of the 51 states and DC, and 0.8× the 26-state median of 9.9%.
Ohio is several markets, not one
Ohio is not one market. Its counties range from 3 insurers to 9 — a gap of 6. Someone at one end of the state is shopping in a genuinely different market from someone at the other, at the same age and the same income.
No county in Ohio is down to a single insurer. Since the previous plan year, 88 counties in Ohio gained an insurer and none lost one.
How many Ohio residents buy on the marketplace
469,616 Ohio residents selected a marketplace plan for 2026. Against the state's under-65 population that is 50 per thousand, below the 26-state median of 79, and 23rd highest of the 26 states on this site.
Of those, 73,309 — 16% — were new rather than renewing, which is a fairly typical mix of new and renewing enrollees (9th of 26).
The spread inside Ohio
Franklin County is the largest county we publish here, with 1,141,930 under-65 residents; Miami County is the smallest, with 89,701. Franklin County has 8 insurers offering 130 plans, and Miami County has 8 offering 130.
The widest choice in Ohio is in Lorain County — 9 insurers, 138 plans. The narrowest is Richland County, with 4 insurers and 66 plans. Same state, same rules, 72 more plans to choose from.
Uninsured rates range from 4.5% in Delaware County to 13.4% in Wayne County — 3.0 times as high, within one state.
The 25 largest counties in Ohio
By under-65 population, covering 75% of the state's under-65 residents. Ohio has 88 counties with complete federal data; we publish pages for the largest.
| County | Under 65 | Uninsured | Insurers | Plans | Per 1,000 |
|---|---|---|---|---|---|
| Franklin County | 1,141,930 | 10.1% | 8 | 130 | 61 |
| Cuyahoga County | 962,545 | 7.9% | 8 | 119 | 56 |
| Hamilton County | 672,238 | 8.0% | 8 | 130 | 54 |
| Summit County | 424,484 | 7.4% | 8 | 125 | 47 |
| Montgomery County | 424,182 | 8.4% | 8 | 130 | 56 |
| Lucas County | 340,088 | 7.2% | 8 | 121 | 53 |
| Butler County | 324,516 | 7.9% | 8 | 130 | 49 |
| Stark County | 291,971 | 7.4% | 8 | 130 | 47 |
| Lorain County | 250,183 | 7.7% | 9 | 138 | 45 |
| Warren County | 211,958 | 5.5% | 8 | 130 | 48 |
| Delaware County | 200,673 | 4.5% | 7 | 113 | 49 |
| Lake County | 178,657 | 6.3% | 7 | 105 | 46 |
| Clermont County | 172,881 | 7.0% | 8 | 130 | 47 |
| Mahoning County | 168,115 | 7.7% | 7 | 114 | 48 |
| Trumbull County | 151,923 | 9.6% | 7 | 114 | 43 |
| Licking County | 148,767 | 6.3% | 6 | 97 | 45 |
| Medina County | 146,521 | 5.8% | 8 | 125 | 42 |
| Fairfield County | 137,102 | 6.2% | 7 | 113 | 45 |
| Greene County | 133,893 | 5.9% | 8 | 130 | 43 |
| Portage County | 126,874 | 7.0% | 8 | 125 | 42 |
| Clark County | 106,240 | 8.5% | 8 | 130 | 62 |
| Wood County | 105,567 | 6.2% | 7 | 106 | 44 |
| Richland County | 92,782 | 9.7% | 4 | 66 | 42 |
| Wayne County | 90,989 | 13.4% | 7 | 113 | 37 |
| Miami County | 89,701 | 7.1% | 8 | 130 | 46 |
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release. "Per 1,000" is marketplace plan selections per thousand under-65 residents.
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