QHP Index

What people actually pay, after the tax credit

The premium on a marketplace plan is almost never what anyone pays. These are the counties where the gap between the two is largest, in 2026 — the average listed premium against the average actually paid once the advance premium tax credit was applied.

CountyStateAverage listedAverage paidDifferencePeople enrolled
Wirt CountyWest Virginia $1,640$239 $1,401 123
Tyler CountyWest Virginia $1,606$225 $1,381 247
Ritchie CountyWest Virginia $1,624$259 $1,365 211
Monroe CountyWest Virginia $1,488$148 $1,340 553
Monroe CountyFlorida $1,478$163 $1,315 18,549
Pleasants CountyWest Virginia $1,574$265 $1,309 153
Braxton CountyWest Virginia $1,480$177 $1,303 334
Clay CountyWest Virginia $1,428$160 $1,268 204
Hamilton CountyFlorida $1,307$42 $1,265 4,532
Gilmer CountyWest Virginia $1,441$177 $1,264 175
Mason CountyWest Virginia $1,467$205 $1,262 703
Webster CountyWest Virginia $1,416$156 $1,260 190
Jackson CountyWest Virginia $1,448$193 $1,255 739
Calhoun CountyWest Virginia $1,435$181 $1,254 202
Wayne CountyWest Virginia $1,439$186 $1,253 1,052
Wetzel CountyWest Virginia $1,447$203 $1,244 412
Roane CountyWest Virginia $1,470$234 $1,236 383
Mingo CountyWest Virginia $1,422$187 $1,235 576
Nicholas CountyWest Virginia $1,452$218 $1,234 734
Pocahontas CountyWest Virginia $1,378$152 $1,226 344
Kent CountyTexas $1,303$88 $1,215 42
Hot Springs CountyWyoming $1,382$171 $1,211 409
Wood CountyWest Virginia $1,420$210 $1,210 2,421
Wyoming CountyWest Virginia $1,375$167 $1,208 558
Greenbrier CountyWest Virginia $1,384$178 $1,206 1,527
Lincoln CountyWest Virginia $1,377$174 $1,203 491
McDowell CountyWest Virginia $1,342$146 $1,196 373
Preston CountyWest Virginia $1,383$188 $1,195 985
Summers CountyWest Virginia $1,366$186 $1,180 267
Barbour CountyWest Virginia $1,323$150 $1,173 493
Hancock CountyWest Virginia $1,372$202 $1,170 813
Mercer CountyWest Virginia $1,344$177 $1,167 1,915
Upshur CountyWest Virginia $1,324$165 $1,159 776
Randolph CountyWest Virginia $1,340$185 $1,155 1,010
Weston CountyWyoming $1,379$224 $1,155 479
Apache CountyArizona $1,331$179 $1,152 1,513
Logan CountyWest Virginia $1,334$185 $1,149 805
Doddridge CountyWest Virginia $1,374$228 $1,146 177
Cabell CountyWest Virginia $1,343$202 $1,141 3,551
Boone CountyWest Virginia $1,346$211 $1,135 527
Putnam CountyWest Virginia $1,415$280 $1,135 1,826
Fayette CountyWest Virginia $1,326$193 $1,133 1,159
Marshall CountyWest Virginia $1,343$213 $1,130 706
Niobrara CountyWyoming $1,399$269 $1,130 163
Taylor CountyWest Virginia $1,347$226 $1,121 440
La Paz CountyArizona $1,292$172 $1,120 759
Brooke CountyWest Virginia $1,358$238 $1,120 635
Platte CountyWyoming $1,340$222 $1,118 576
Washakie CountyWyoming $1,253$151 $1,102 672
Tucker CountyWest Virginia $1,324$223 $1,101 236
Hampshire CountyWest Virginia $1,305$206 $1,099 714
Pendleton CountyWest Virginia $1,253$156 $1,097 304
Marion CountyWest Virginia $1,311$217 $1,094 1,441
Raleigh CountyWest Virginia $1,307$213 $1,094 2,038
Kanawha CountyWest Virginia $1,300$210 $1,090 5,961
Carbon CountyWyoming $1,289$206 $1,083 930
Sweetwater CountyWyoming $1,310$228 $1,082 2,133
Goshen CountyWyoming $1,256$188 $1,068 1,061
Lewis CountyWest Virginia $1,346$286 $1,060 530
Johnson CountyWyoming $1,239$187 $1,052 987
Grant CountyWest Virginia $1,223$172 $1,051 396
Ontonagon CountyMichigan $1,192$142 $1,050 358
Uinta CountyWyoming $1,207$166 $1,041 1,385
Harrison CountyWest Virginia $1,246$206 $1,040 2,363
Morgan CountyWest Virginia $1,248$210 $1,038 613
Converse CountyWyoming $1,280$243 $1,037 853
Ohio CountyWest Virginia $1,293$270 $1,023 1,141
Fremont CountyWyoming $1,262$241 $1,021 2,690
Sublette CountyWyoming $1,260$248 $1,012 916
Mohave CountyArizona $1,200$190 $1,010 12,387
Stonewall CountyTexas $1,099$91 $1,008 112
Yuma CountyArizona $1,203$197 $1,006 6,720
Mineral CountyWest Virginia $1,252$246 $1,006 779
Lafayette CountyFlorida $1,085$82 $1,003 1,541
Big Horn CountyWyoming $1,193$190 $1,003 1,175
Meade CountyKansas $1,194$197 $997 188
Union CountyFlorida $1,094$103 $991 1,328
Park CountyWyoming $1,208$217 $991 3,570
Aleutians WestAlaska $1,265$278 $987 34
Natrona CountyWyoming $1,205$221 $984 5,073
Stanton CountyKansas $1,106$125 $981 80
Hardy CountyWest Virginia $1,131$153 $978 717
Campbell CountyWyoming $1,235$257 $978 2,717
Concho CountyTexas $1,073$98 $975 297
Nolan CountyTexas $1,077$102 $975 1,396
Crockett CountyTexas $1,027$55 $972 1,174
Schleicher CountyTexas $1,100$130 $970 257
Copper RiverAlaska $1,179$212 $967 104
Schoolcraft CountyMichigan $1,175$209 $966 390
Sheridan CountyWyoming $1,204$241 $963 2,465
Laramie CountyWyoming $1,180$219 $961 5,330
Hardee CountyFlorida $1,062$103 $959 3,278
Mitchell CountyTexas $1,074$115 $959 764
Crook CountyWyoming $1,149$192 $957 766
Eastland CountyTexas $1,053$97 $956 2,316
Clay CountyTexas $994$47 $947 4,092
Duval CountyTexas $1,009$62 $947 1,597
Runnels CountyTexas $1,056$110 $946 1,188
Baraga CountyMichigan $1,061$116 $945 275
Wilbarger CountyTexas $1,022$77 $945 1,716
Gogebic CountyMichigan $1,114$171 $943 804
Coleman CountyTexas $1,054$112 $942 1,113
Sutton CountyTexas $1,063$122 $941 421
Menominee CountyMichigan $1,098$159 $939 1,324
Archer CountyTexas $999$60 $939 4,075
Seward CountyKansas $1,055$117 $938 1,249
Luce CountyMichigan $1,068$130 $938 236
Jones CountyTexas $1,042$104 $938 1,615
Northampton CountyNorth Carolina $1,075$138 $937 1,227
Menard CountyTexas $1,059$122 $937 245
Albany CountyWyoming $1,159$222 $937 2,221
Monongalia CountyWest Virginia $1,192$256 $936 2,944
Berkeley CountyWest Virginia $1,131$197 $934 4,645
Morton CountyKansas $1,106$174 $932 162
Jim Hogg CountyTexas $964$32 $932 867
Haskell CountyTexas $1,012$81 $931 1,002
Stephens CountyTexas $1,028$97 $931 1,122
Lincoln CountyWyoming $1,139$209 $930 2,010
McCulloch CountyTexas $1,043$114 $929 809
Taylor CountyFlorida $1,073$145 $928 2,695
Washington CountyFlorida $1,034$107 $927 2,866
Yukon KoyukukAlaska $1,248$322 $926 86
Scurry CountyTexas $1,028$102 $926 1,435
Stevens CountyKansas $1,093$168 $925 304
Fentress CountyTennessee $1,055$130 $925 1,994
Glades CountyFlorida $1,053$129 $924 2,049
Callahan CountyTexas $1,044$122 $922 1,950
Yavapai CountyArizona $1,220$299 $921 12,376
Mason CountyTexas $1,003$82 $921 2,394
Washington CountyNorth Carolina $1,090$170 $920 818
Coke CountyTexas $1,001$81 $920 460
Sterling CountyTexas $972$52 $920 339
Kodiak IslandAlaska $1,197$278 $919 583
Putnam CountyMissouri $1,096$179 $917 241
Van Buren CountyTennessee $1,026$109 $917 488
Bertie CountyNorth Carolina $1,035$119 $916 1,163
Ford CountyKansas $1,064$149 $915 1,462
Kearny CountyKansas $1,083$168 $915 230
Gates CountyNorth Carolina $1,071$158 $913 545
Hardeman CountyTexas $1,035$122 $913 409
Shackelford CountyTexas $1,009$96 $913 439
Kimble CountyTexas $984$72 $912 1,577
Wallace CountyKansas $1,121$210 $911 85
Jones CountyNorth Carolina $1,066$156 $910 995
Reagan CountyTexas $955$45 $910 439
Perry CountyTennessee $1,002$95 $907 600
Finney CountyKansas $1,068$164 $904 1,888
Lewis CountyTennessee $1,020$119 $901 851
Throckmorton CountyTexas $1,020$119 $901 213
Comanche CountyTexas $1,006$108 $898 1,776
Hertford CountyNorth Carolina $1,016$119 $897 1,051
Clay CountyTennessee $1,023$126 $897 793
Clark CountyKansas $1,073$177 $896 126
White CountyTennessee $1,013$118 $895 2,503
Fisher CountyTexas $1,035$140 $895 560
Grant CountyKansas $1,061$167 $894 391
Iron CountyMichigan $1,055$161 $894 794
Delta CountyMichigan $1,037$144 $893 2,383
Dixie CountyFlorida $1,043$152 $891 2,033
Haskell CountyKansas $1,032$141 $891 253
Cumberland CountyTennessee $1,043$152 $891 4,864
Edgecombe CountyNorth Carolina $983$95 $888 2,322
Halifax CountyNorth Carolina $1,008$121 $887 3,861
Wichita CountyTexas $975$88 $887 16,108
Tom Green CountyTexas $970$86 $884 15,979
Beaufort CountyNorth Carolina $1,022$141 $881 4,074
Pamlico CountyNorth Carolina $1,112$231 $881 1,175
Pickett CountyTennessee $1,028$147 $881 462
Baylor CountyTexas $1,000$119 $881 362
Lenoir CountyNorth Carolina $1,037$158 $879 3,715
Foard CountyTexas $1,028$149 $879 174
Piute CountyUtah $922$43 $879 199
Hoonah AngoonAlaska $1,049$171 $878 79
Keweenaw CountyMichigan $1,024$147 $877 132
Houston CountyTennessee $992$115 $877 516
Humphreys CountyTennessee $1,013$136 $877 1,176
WrangellAlaska $1,145$269 $876 98
Kimball CountyNebraska $1,112$236 $876 155
Dickinson CountyMichigan $1,019$144 $875 1,549
Lincoln CountyTennessee $1,018$144 $874 2,268
Irion CountyTexas $931$58 $873 1,372
Jefferson CountyWest Virginia $1,121$248 $873 2,267
Taylor CountyTexas $982$110 $872 15,037
Hyde CountyNorth Carolina $1,088$219 $869 449
Rusk CountyWisconsin $1,104$235 $869 783
Overton CountyTennessee $996$128 $868 1,856
Alger CountyMichigan $1,061$195 $866 573
Martin CountyNorth Carolina $1,018$152 $866 1,779
Wayne CountyMissouri $978$113 $865 809
Lawrence CountyTennessee $1,004$139 $865 2,875
Nevada CountyArkansas $998$134 $864 344
Issaquena CountyMississippi $958$97 $861 77
Wayne CountyTennessee $992$131 $861 1,186
Searcy CountyArkansas $981$121 $860 454
Moore CountyTennessee $1,030$170 $860 327
Garden CountyNebraska $1,011$152 $859 249
Brown CountyTexas $926$67 $859 7,389
Stewart CountyTennessee $984$127 $857 913
Jackson CountyTennessee $982$126 $856 1,333
Dickens CountyTexas $972$116 $856 193

What any one person pays depends on their income and household, and only HealthCare.gov can work it out. These are county averages CMS published, not quotes.

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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.