The cheapest health insurance counties in America (2026)

Browse Health Plans team · Reviewed by a licensed health insurance advisor · Updated October 26, 2026

The cheapest place in America to buy a Marketplace health plan at full price in 2026 is southern New Hampshire, where a 40-year-old can get the lowest-priced Bronze plan for $317 a month in Hillsborough, Rockingham, Merrimack, Strafford and Belknap counties. The rest of New Hampshire follows at $324, then Burleigh County, North Dakota at $332, Horry County, South Carolina at $336, and Woodbury County, Iowa at $338. Across the 2,055 counties in the 30 states that use HealthCare.gov, the median county's cheapest Bronze for a 40-year-old is $482, and only 33 counties come in under $350.

Every figure here is the full monthly premium, before any tax credit, for one 40-year-old non-smoker, from the official 2026 plan file (CMS QHP Landscape PY2026, snapshot August 4, 2026). We ranked every county by its lowest-priced Bronze plan at that age, the same figure shown on each county page of this site; how we price explains the method. The 20 states and DC that run their own marketplaces are not in the federal file and are not ranked. A low full price is good news for households that pay full price, but as the second half of this guide shows, the cheapest counties are often not the cheapest places for someone with a tax credit.

The 25 lowest-priced counties with 50,000 or more residents

Every row links to that county's prices, either its own page or the tool with its ZIP code filled in. The deductible shown is for the cheapest Bronze plan itself, because the lowest premium in one county can carry a much higher deductible than the lowest premium in another.

One adult, 40, non-tobacco, full monthly premium of the lowest-priced Bronze plan sold in the county, from the CMS plan-year 2026 Individual Medical file (snapshot August 4, 2026). Counties under 50,000 residents are excluded; two smaller counties, Coos and Sullivan in New Hampshire, also price at $324, and Plymouth County, Iowa matches Woodbury at $338.

Four states own the list: New Hampshire, Iowa, North Dakota and South Carolina between them fill 22 of the 25 rows, with Michigan's three Detroit-area counties taking the rest. That is not a coincidence. The cheapest Bronze in a county is set by whichever insurer prices most aggressively in that rating area, and in each of these states one or two insurers have filed a Bronze plan well below the rest of the market. New Hampshire also uses a single rating area for the whole state, so the only reason its counties differ at all is which plans are sold in each one, which is why five counties share the identical $317 price.

Look at the deductible column before you get excited about a price. The $317 plan in Hillsborough County carries a $6,500 deductible, while the $336 plan in Horry County and the $345 plans around Detroit are priced that low partly because their deductible is $10,600, the legal maximum for 2026. For a healthy person who rarely uses care, that difference may not matter. For anyone expecting a hospital stay, a $4,100 gap in the deductible is worth more than the $28 a month saved on the premium.

The cheapest county in every HealthCare.gov state

The lowest county in a state tells you where the floor is, and the median county tells you what a typical resident sees. The gap between them is the spread inside the state, and in some states it is enormous.

Cheapest Bronze plan for one 40-year-old, full price, CMS plan-year 2026 file (snapshot August 4, 2026). Medians are across counties, not weighted by population. Where several counties tie for the lowest price, the first few are named.

Two patterns stand out. First, the cheapest counties are not in the states people expect. Texas does not crack the top 25 at all: its cheapest county, Cottle, is rural at $352 and its big cities sit around $375 to $450. Florida's floor is $427, higher than the median county in Iowa, Indiana or New Hampshire. Second, the spread inside a state is often bigger than the gap between states. Arizona goes from $375 in Pima County (Tucson) to $781 in Apache County, and Florida from $427 in Brevard to $949 in Monroe County. Our guides to prices at 40 in every state and Texas versus Florida go deeper on those two states.

The cheapest large metros

Most people do not live in Belknap County. Here are the lowest-priced counties with at least half a million residents, which is where the price floor for a big-city household sits.

Counties with 500,000 or more residents, one adult aged 40, full price, CMS plan-year 2026 file (snapshot August 4, 2026).

The Midwest wins the big-city ranking. Des Moines, the three Detroit-area counties, Madison, Cincinnati and Grand Rapids all price a 40-year-old's Bronze under $360 a month, and the Ohio metros do it with 125 to 130 plans from eight insurers, which is about as competitive as a Marketplace gets. Houston and Tucson, the first non-Midwest metros on the list, are $375.

The catch: a cheap county usually means a small tax credit

The premium tax credit is the difference between the second-lowest Silver plan in your county, the benchmark, and a fixed share of your income. A county with a low benchmark produces a small credit, and the cheapest Bronze counties tend to have low benchmarks too. In New Hampshire the benchmark for a 40-year-old is $388 a month, the lowest in the country. The law expects a single person earning $50,000 to contribute 9.96% of income, which is $415 a month, so in New Hampshire that person gets no credit at all and pays the full $317. Here is the same single 40-year-old at three incomes in cheap-Bronze counties and in two Texas counties with a high benchmark:

Cheapest Bronze after the estimated 2026 premium tax credit for a single 40-year-old, household of one, 2026 rules (IRS Rev. Proc. 2025-25, HHS 2025 poverty guidelines). $35,000 is 224% of the poverty level, $50,000 is 319% and $60,000 is 383%. The Marketplace sets the final credit.

The ranking flips completely. At $50,000 the cheapest place on the list is Hidalgo County, Texas at $147 a month, where the full price is $63 higher than New Hampshire's but the benchmark is $261 higher, so the credit covers most of the Bronze premium. The New Hampshire counties that top the full-price ranking are the most expensive on this table at $317, because there is no credit to apply. The same thing happens, less dramatically, in Tucson, where a low $449 benchmark leaves a $50,000 earner with only a $34 credit.

The practical rule: if your income is under the 400% line ($62,600 for one person, $84,600 for a couple, $128,600 for a family of four in 2026), a county's full-price ranking tells you very little about what you will pay. Look at the after-credit number for your own household, which the price comparison tool calculates for every plan in your ZIP code. If your income is above the line, the enhanced credits that applied from 2021 through 2025 are gone, there is no credit at any income, and the full-price ranking above is exactly what you face. Tax rules here are summarised in general terms; confirm with your tax professional. Our guide to how the 2026 premium tax credit works covers the maths in detail.

What the cheapest Bronze plan buys

Every plan on these lists is a Bronze HMO or EPO with a local network. Bronze plans cover about 60% of the average enrollee's costs, and nearly all of the cheapest ones put the full deductible in front of everything except preventive care and, in some plans, a few primary-care visits. The deductibles on the cheapest plans in the top 25 run from $6,500 in southern New Hampshire to $7,500 across Iowa and North Dakota, and $10,600 in South Carolina and Michigan. The out-of-pocket maximum is $10,000 to $10,600 everywhere on the list.

That makes the cheapest Bronze a catastrophic plan with preventive care, which suits a healthy household that wants protection against a large bill and little else. It is the wrong plan for someone who fills prescriptions every month, sees a specialist regularly, or earns under about 250% of the poverty level and could get cost-sharing reductions on a Silver plan instead. In New Hampshire's cheap counties, the cheapest Gold plan for a 40-year-old is $417, only $100 more than the cheapest Bronze, with a far lower deductible; the tier guide works through when that trade is worth it.

The private alternative in the cheap states

Private plans are priced on age, sex and health rather than county or income, so a healthy applicant sees a similar starting range anywhere in a state. For a healthy 40-year-old the starting ranges our advisors typically quote are $194 to $622 a month for a man and $229 to $673 for a woman in Iowa, $177 to $601 and $206 to $644 in Michigan, $194 to $622 and $232 to $677 in South Carolina, and $155 to $574 and $177 to $607 in Ohio. For New Hampshire and North Dakota the carrier tables do not list the state yet, so the ranges on their state pages are estimates built from the states around them, and an advisor confirms the exact price.

The honest comparison runs both ways. A healthy household paying full price often finds the private low end well under the Marketplace floor, with a lower deductible and a wider network. But private plans are medically underwritten and are not ACA coverage: the application asks health questions, and the carrier can decline you, charge more, or exclude a condition. They do not qualify for the tax credit. Anyone with a tax credit, or with an ongoing condition, usually does better on the Marketplace, which must accept everyone at the standard rate and cannot exclude anything. The ranges are starting points for healthy applicants after the usual adjustment our advisors apply, and nothing here is a promise of what you will pay.

How to use this ranking

• Do not move for a health plan. The gap between the cheapest county and the median is about $165 a month at full price, and far less after a credit. It is a factor in a move you are already making, not a reason for one.
• Price your own ZIP, not the state. Michigan's cheapest county is $345 and its most expensive is $528; the state median tells a Detroit household almost nothing. Enter your ZIP in the tool and read the after-credit figure.
• If you are near a county line, check both. Plans are priced by rating area, and the same insurer's Bronze can be $20 to $50 cheaper one county over. The county pages linked above list every plan sold in each one.
• Check the deductible, not just the premium. A $10,600 deductible plan that is $20 a month cheaper than a $7,500 one is only the better deal if you never use it.
• Above the 400% line, compare both markets. Full price is what you pay on the Marketplace, so the private ranges above are worth a conversation if you are healthy. Below the line, the Marketplace with its credit almost always wins.

Questions people ask

Sources: CMS QHP Landscape PY2026 Individual Medical file (data.healthcare.gov, snapshot August 4, 2026) for every Marketplace premium, benchmark, deductible, plan count and insurer count; HHS 2025 poverty guidelines (90 FR 5917) and IRS Rev. Proc. 2025-25 for the credit maths; U.S. Census Bureau county population estimates for the size cut-offs; carrier rate tables used by our advisors for private ranges. Figures are monthly, non-tobacco, before any credit unless stated, and can change before Open Enrollment. Tax rules summarised here are general; confirm with your tax professional.