{
"name": "State health insurance marketplace assistance by state: who runs it, where subsidies start and stop, and what the state adds",
"description": "One record per US state and the District of Columbia, stating who operates its health insurance marketplace, the income at which premium tax credit eligibility begins there, whether a coverage gap exists below it, and what the state itself adds on top of the federal credit. When the ACA's enhanced premium tax credits lapsed on 31 December 2025 a group of states stood up or expanded their own premium assistance to absorb part of the loss, and they did so on completely different terms: New Mexico backfills the full loss below 400% of the poverty line and caps benchmark premiums at 8.5% of income above it; New Jersey's assistance runs to 600% of the poverty line; Maryland covers the whole loss below 200% and part of it to 400%; California stops at 165%; Colorado pays a flat monthly amount; Washington pays per member per month. In ten states that never adopted the Medicaid expansion, a household below the poverty line still qualifies for nothing at all. Whether the federal cutoff at 400% of the poverty line is a cliff or a slope therefore depends entirely on the state, and no page states the answer for all fifty-one. Answers 'does my state have its own health insurance subsidy', 'what is the income limit for marketplace insurance in [state]', 'am I in the coverage gap', 'does [state] have a health insurance mandate', and 'when does open enrollment end in [state]'.",
"url": "https://referencesource.org/state-marketplace-assistance-programs/",
"licence": "Facts extracted from state marketplace, state insurance department and state Medicaid agency pages. Programme names, income thresholds, payment amounts, mandate penalties and enrollment dates are statutory or administrative facts and not copyrightable (Feist, 1991). Each record cites the state page it came from and quotes a short passage linking back. Compilations by third parties (KFF, healthinsurance.org) are used only to locate the state's own page and are never the cited source for a value.",
"last_verified": "2026-08-14",
"stale_after": "2026-12-12",
"sources": [
"https://www.healthinsurance.org/alabama/",
"https://www.healthinsurance.org/alaska/",
"https://www.healthinsurance.org/arizona/",
"https://www.healthinsurance.org/arkansas/",
"https://www.coveredca.com/support/financial-help/",
"https://connectforhealthco.com/new-customers/tips-for-choosing-a-plan/colorado-premium-assistance/",
"https://accesshealthct.com/financial-help/",
"https://www.healthinsurance.org/delaware/",
"https://hbx.dc.gov/page/basic-health-plan",
"https://www.healthinsurance.org/florida/",
"https://georgiaaccess.gov/",
"https://www.healthinsurance.org/hawaii/",
"https://www.yourhealthidaho.org/",
"https://getcoveredillinois.gov/get-started/about-the-marketplace.html",
"https://www.healthinsurance.org/indiana/",
"https://www.healthinsurance.org/iowa/",
"https://www.healthinsurance.org/kansas/",
"https://www.healthinsurance.org/kentucky/",
"https://www.healthinsurance.org/louisiana/",
"https://www.coverme.gov/learn/how-to-enroll/open-enrollment",
"https://www.marylandhealthconnection.gov/maryland-premium-assistance/",
"https://www.mahealthconnector.org/wp-content/uploads/ConnectorCare-Overview-2026.pdf",
"https://www.healthinsurance.org/michigan/",
"https://www.healthinsurance.org/minnesota/",
"https://www.healthinsurance.org/mississippi/",
"https://www.healthinsurance.org/missouri/",
"https://www.healthinsurance.org/montana/",
"https://www.healthinsurance.org/nebraska/",
"https://www.nevadahealthlink.com/",
"https://www.healthinsurance.org/new-hampshire/",
"https://nj.gov/getcoverednj/",
"https://www.nj.gov/getcoverednj/financialhelp/premiums/",
"https://bewellnm.com/answers/federal-changes/",
"https://info.nystateofhealth.ny.gov/costsavings",
"https://info.nystateofhealth.ny.gov/EssentialPlan",
"https://www.healthinsurance.org/north-carolina/",
"https://www.healthinsurance.org/north-dakota/",
"https://www.healthinsurance.org/ohio/",
"https://www.healthinsurance.org/oklahoma/",
"https://www.healthinsurance.org/oregon/",
"https://www.pennie.com/",
"https://www.healthsourceri.com/",
"https://www.healthinsurance.org/south-carolina/",
"https://www.healthinsurance.org/south-dakota/",
"https://www.healthinsurance.org/tennessee/",
"https://www.healthinsurance.org/texas/",
"https://www.healthinsurance.org/utah/",
"https://info.healthconnect.vermont.gov/learn-more/financial-help",
"https://www.marketplace.virginia.gov/federalchanges",
"https://www.wahbexchange.org/about-the-exchange/initiatives/cascade-care/cascade-care-savings/",
"https://www.wahbexchange.org/content/dam/materials/communications/legislative/2025/WAHBE_Final_PY_2026_Cascade_Care_Savings_Maximum_Per_Member_Per_Month_Methodology.pdf",
"https://www.healthinsurance.org/west-virginia/",
"https://www.healthinsurance.org/wisconsin/",
"https://www.healthinsurance.org/wyoming/"
],
"records": [
{
"state": "Alabama",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "alabama",
"url": "https://referencesource.org/state-marketplace-assistance-programs/alabama/",
"source": "https://www.healthinsurance.org/alabama/",
"source_quote": "You may find affordable health insurance coverage in Alabama by enrolling through HealthCare.gov. This is especially true if you qualify for premium tax credits (subsidies), and most Alabama enrollees are subsidy-eligible. During the open enrollment period for 2026 coverage, 91% of Alabama Marketplace enrollees qualified for premium subsidies. These premium subsidies saved enrollees an average of about $678/month. For enrollees who qualify for subsidies, the average after-subsidy premium was only $70/month in 2026. 9 However, subsidy enhancements that had been in effect for five years were allowed to expire at the end of 2025, after Congressional Republicans refused to extend them. This means subsidies are >https://www.healthinsurance.org/blog/marketplace-enrollees-face-return-of-the-subsidy-cliff/< no longer available to households with income above 400% of the federal poverty level , and it also means subsidies >https://www.healthinsurance.org/blog/how-sunsetting-arps-subsidy-enhancements-would-affect-aca-subsidy-amounts/< don’t cover as much of enrollees’ premiums in 2026 . The overall average net premium (including people who pay full price) was $65/month in 2025 10 in Alabama’s Marketplace, and grew to $126/month in 2026, 11 due to the expiration of the federal subsidy enhancements. If your household income isn\u2019t more than 250% of the federal poverty level, you may also qualify for cost-sharing reductions (CSR). These subsidies can make your deductible and other out-of-pocket expenses smaller than they would otherwise be, as long as you select a Silver-level plan. Source: CMS.gov 12 If you\u2019re eligible for APTC and CSR benefits you can utilize both as long as you select a Silver-level plan (APTC can be used with plans at any metal level, but CSR benefits are only available on Silver plans). Depending on your income and circumstances, you may find that you\u2019re eligible for free or low cost health coverage through Alabama Medicaid or ALL Kids (CHIP). >https://www.healthinsurance.org/medicaid/alabama/< Check to see if you meet the criteria for these programs in Alabama. When can I enroll in an ACA-compliant plan in Alabama? The open enrollment period for 2027 health coverage in Alabama runs from November 1, 2026 through January 15, 2027.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Alaska",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "alaska",
"url": "https://referencesource.org/state-marketplace-assistance-programs/alaska/",
"source": "https://www.healthinsurance.org/alaska/",
"source_quote": "Alaska uses the federally facilitated HealthCare.gov Marketplace platform, where plans are available from two private health insurance companies \u2014 Moda and Premera.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Arizona",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "December 15, 2026",
"open_enrollment_year": "2027",
"id": "arizona",
"url": "https://referencesource.org/state-marketplace-assistance-programs/arizona/",
"source": "https://www.healthinsurance.org/arizona/",
"source_quote": "Arizona Marketplace quick facts Type of health insurance Marketplace Federally-facilitated Marketplace ( >https://www.healthcare.gov< HealthCare.gov ) Average monthly premium after subsidies (2026 plans) 2 $229 Number of carriers offering 2026 plans 3 7 Consumers paying <$10 premium after subsidies (2026 plans) 2 17% Frequently asked questions about health insurance in Arizona Frequently asked questions about health insurance in Arizona Who can buy Marketplace health insurance in Arizona? To buy Marketplace health coverage in Arizona: 4 You must live in Arizona. You must be lawfully present in the U.S. You can\u2019t be incarcerated. You can\u2019t be enrolled in Medicare. To qualify for financial assistance (which depends on your household income) through the Arizona Health Insurance Marketplace: You can’t be eligible for affordable coverage offered by an employer. You can use >https://www.healthinsurance.org/obamacare/employer-health-plan-affordability-calculator/< this tool to see if the employer-sponsored coverage available to you is considered affordable. You can’t be eligible for AHCCCS (Medicaid) or KidsCare (CHIP) You can’t be eligible for premium-free Medicare Part A. 5 If married, file a joint tax return. 6 Not be able to be claimed by someone else as a tax dependent. 6 When can I enroll in an ACA-compliant plan in Arizona? Arizona’s >https://www.healthinsurance.org/open-enrollment/< open enrollment period for 2026 coverage ended on January 15, 2026. The next open enrollment period, for coverage effective in 2027, will run from November 1, 2026 to December 15, 2026.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Arkansas",
"marketplace_type": "state-based marketplace on federal platform (SBM-FP)",
"marketplace_name": "Arkansas Health Insurance Marketplace",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "arkansas",
"url": "https://referencesource.org/state-marketplace-assistance-programs/arkansas/",
"source": "https://www.healthinsurance.org/arkansas/",
"source_quote": "Arkansas residents enroll in ACA-compliant plans through a state-based exchange/Marketplace that utilizes the federal enrollment platform (SBE-FP). This means people enroll through HealthCare.gov, but the state (via the Arkansas Insurance Department) oversees the exchange plans and runs its own outreach and assistance programs.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "California",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Covered California",
"marketplace_url": "https://www.coveredca.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "California Premium Subsidy",
"state_premium_income_range": "up to 150% of the federal poverty level",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "yes",
"individual_mandate_penalty": "the greater of 2.5% of household income or $900 per adult and $450 per child, up to a family maximum of $2,700",
"id": "california",
"url": "https://referencesource.org/state-marketplace-assistance-programs/california/",
"source": "https://www.coveredca.com/support/financial-help/",
"source_quote": "Financial Help",
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Colorado",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Connect for Health Colorado",
"marketplace_url": "https://connectforhealthco.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "Colorado Premium Assistance",
"state_premium_income_range": "up to 400% of the federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "$80 for the first household member and $29 for each subsequent household member that pays a premium",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "2025-11-01",
"open_enrollment_end": "2026-01-15",
"open_enrollment_year": "2026",
"id": "colorado",
"url": "https://referencesource.org/state-marketplace-assistance-programs/colorado/",
"source": "https://connectforhealthco.com/new-customers/tips-for-choosing-a-plan/colorado-premium-assistance/",
"source_quote": "$80 for the first household member and $29 for each subsequent household member that pays a premium",
"verified_fields": [
"state_premium_amount"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Connecticut",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Access Health CT",
"marketplace_url": "https://www.accesshealthct.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "Covered CT Program",
"state_premium_income_range": "up to 175% of the federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "The State of Connecticut will pay a customer's portion of their monthly payment (premium) directly to the customer's insurance company and it will also pay for the cost-sharing amounts (deductibles, co-pays, and co-insurance)",
"state_cost_sharing_program": "Covered CT Program",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "connecticut",
"url": "https://referencesource.org/state-marketplace-assistance-programs/connecticut/",
"source": "https://accesshealthct.com/financial-help/",
"source_quote": " Immigration Status You may qualify for some type of financial help or low- or no-cost coverage. By providing your income and household information, you will see if you qualify for financial help to pay for your health coverage. This benefit is only available through Access Health CT. You might qualify depending on: Household size Household Income Home address 2026 Temporary Premium Assistance provides additional financial help to lower monthly health coverage costs for eligible Connecticut residents. The amount of help is based on the number of people in your household and your household income. You must call us to enroll at 1-855-805-4325. Learn more about this additional financial help and see if you qualify (opens in new window). Also, through Access Health CT, Connecticut residents who meet specific eligibility requirements pay $0 for their health insurance coverage with the Covered CT Program (opens in new window).",
"verified_fields": [
"individual_mandate",
"marketplace_name",
"marketplace_url",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Delaware",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "delaware",
"url": "https://referencesource.org/state-marketplace-assistance-programs/delaware/",
"source": "https://www.healthinsurance.org/delaware/",
"source_quote": "Delaware uses the federally- facilitated Marketplace, >https://www.healthcare.gov/< HealthCare.gov . Delaware residents who need to obtain their own health insurance can use HealthCare.gov to shop for individual and family health coverage offered by private health insurers.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "District of Columbia",
"marketplace_type": "State-based marketplace",
"marketplace_name": "DC Health Link",
"marketplace_url": "https://www.dchealthlink.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "200% of the federal poverty level (Medicaid covers up to 138% FPL; Healthy DC Plan BHP covers 138% to 200% FPL; premium tax credit eligibility begins above 200% FPL)",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "Healthy DC Plan",
"individual_mandate": "yes",
"individual_mandate_penalty": "the same as the federal shared responsibility payment as it stood on December 15, 2017: the greater of 2.5% of household income or $695 per uninsured adult and $347.50 per uninsured child, up to a family maximum of the District average bronze-plan premium (the District shared responsibility payment is reduced by any federal shared responsibility payment owed)",
"open_enrollment_start": "2026-11-01",
"open_enrollment_end": "2026-12-31",
"open_enrollment_year": "2027",
"id": "district-of-columbia",
"url": "https://referencesource.org/state-marketplace-assistance-programs/district-of-columbia/",
"source": "https://hbx.dc.gov/page/basic-health-plan",
"source_quote": "Healthy DC Plan is the name of the BHP in DC. For more information on Healthy DC Plan see www.HealthyDCPlan.com . For information on the Basic Health Plan Advisory Council and Carrier Working Groups, click here . Public Comment Request - DC HBX drafted a Basic Health Plan Blueprint to submit to the federal Centers for Medicare & Medicaid Services (CMS). States choosing to operate a BHP must submit a BHP Blueprint to CMS as an official request for certification of the program.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"individual_mandate_penalty",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Florida",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "florida",
"url": "https://referencesource.org/state-marketplace-assistance-programs/florida/",
"source": "https://www.healthinsurance.org/florida/",
"source_quote": "Florida Rate Review Submissions ” RateReview.HealthCare.gov. Accessed Aug. 3, 2026 ⤶ ” >https://www.healthcare.gov/see-plans/#/< See Plans & Prices ” (zip 33301) HealthCare.gov. Accessed Oct. 31, 2025 ⤶ >https://www.commonwealthfund.org/blog/2014/analysis-finds-no-nationwide-increase-health-insurance-marketplace-premiums?redirect_source=/publications/blog/2014/dec/zero-inflation-nationwide-for-marketplace-premiums<",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Georgia",
"marketplace_type": "state-based marketplace (SBM)",
"marketplace_name": "Georgia Access",
"marketplace_url": "https://georgiaaccess.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "georgia",
"url": "https://referencesource.org/state-marketplace-assistance-programs/georgia/",
"source": "https://georgiaaccess.gov/",
"source_quote": "Open Enrollment for Plan Year 2026 ended on January 15, 2026, but Qualifying Life Events (QLEs) could make you eligible for a Special Enrollment Period (SEP).",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Hawaii",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "hawaii",
"url": "https://referencesource.org/state-marketplace-assistance-programs/hawaii/",
"source": "https://www.healthinsurance.org/hawaii/",
"source_quote": "Hawaii utilizes a federally-facilitated health insurance Marketplace, which means residents enroll through HealthCare.gov, where two private insurers offer individual/family health plans for Hawaii residents.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Idaho",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Your Health Idaho",
"marketplace_url": "https://www.yourhealthidaho.org/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "idaho",
"url": "https://referencesource.org/state-marketplace-assistance-programs/idaho/",
"source": "https://www.yourhealthidaho.org/",
"source_quote": "Your Health Idaho",
"verified_fields": [
"marketplace_name",
"state"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Illinois",
"marketplace_type": "state-based marketplace (SBM)",
"marketplace_name": "Get Covered Illinois",
"marketplace_url": "https://getcovered.illinois.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "illinois",
"url": "https://referencesource.org/state-marketplace-assistance-programs/illinois/",
"source": "https://getcoveredillinois.gov/get-started/about-the-marketplace.html",
"source_quote": "Illinois is moving from HealthCare.gov to a state-based marketplace, where you can apply for financial help and enroll in 2026 health coverage when open enrollment starts on November 1.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Indiana",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "indiana",
"url": "https://referencesource.org/state-marketplace-assistance-programs/indiana/",
"source": "https://www.healthinsurance.org/indiana/",
"source_quote": "Indiana uses the federally-facilitated health insurance Marketplace, HealthCare.gov, where five private insurance companies offer individual/family coverage for 2026.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Iowa",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "iowa",
"url": "https://referencesource.org/state-marketplace-assistance-programs/iowa/",
"source": "https://www.healthinsurance.org/iowa/",
"source_quote": "Iowa uses the federally run >https://www.healthinsurance.org/aca-marketplace/< health insurance exchange , so residents use HealthCare.gov to compare plans and enroll in coverage.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Kansas",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "kansas",
"url": "https://referencesource.org/state-marketplace-assistance-programs/kansas/",
"source": "https://www.healthinsurance.org/kansas/",
"source_quote": "But in June 2026, a judge vacated the federal rule change that had mandated the shorter open enrollment period. 7 HHS could appeal the ruling, or might just continue to use the open enrollment schedule that was used for the past several years, with a January 15 end date. Kansas Marketplace enrollees should pay close attention to any communications they receive regarding deadlines for 2027 coverage. Where do I enroll in a Marketplace plan in Kansas? If you’re eligible for an ACA Marketplace plan, there are a few ways to enroll, with or without free assistance: Online through HealthCare.gov By phone at (800) 318-2596 With the help of an agent/broker, navigator, or certified application counselor (help is available online, over the phone, or in person) Via an approved >https://www.healthinsurance.org/glossary/enhanced-direct-enrollment-ede/< enhanced direct enrollment entity. 8 How can I find affordable health insurance in Kansas? In Kansas, you can find affordable individual and family health insurance through HealthCare.gov \u2013 the ACA Marketplace. Of the roughly 200,000 people who enrolled in coverage through the Kansas Marketplace for 2026, 89% were eligible for premium subsidies (advance premium tax credits, or APTC) that averaged $697/month. After the subsidies were applied, the average subsidy-eligible Kansas Marketplace enrollee was paying about $80/month for their coverage. 9 (Note that for 2026, premium subsidies are still available to most enrollees, but are >https://www.healthinsurance.org/blog/marketplace-enrollees-face-return-of-the-subsidy-cliff/< no longer available to those with household income above 400% of the federal poverty level.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Kentucky",
"marketplace_type": "state-based marketplace (SBM)",
"marketplace_name": "kynect",
"marketplace_url": "https://kynect.ky.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "kentucky",
"url": "https://referencesource.org/state-marketplace-assistance-programs/kentucky/",
"source": "https://www.healthinsurance.org/kentucky/",
"source_quote": "Kentucky residents use a fully state-based health insurance Marketplace \u2013 >https://kynect.ky.gov/< Kynect \u2013 to shop for and purchase ACA >https://www.healthinsurance.org/aca-marketplace/< health insurance Marketplace plans.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Louisiana",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "louisiana",
"url": "https://referencesource.org/state-marketplace-assistance-programs/louisiana/",
"source": "https://www.healthinsurance.org/louisiana/",
"source_quote": "In Louisiana, the >https://www.healthcare.gov/quick-guide/dates-and-deadlines/< open enrollment period for ACA-compliant individual and family health plans runs from November 1 to January 15 (plans must be selected by December 15 to have a January 1 effective date).",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Maine",
"marketplace_type": "state-based marketplace (SBM)",
"marketplace_name": "CoverME.gov",
"marketplace_url": "https://www.coverme.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "maine",
"url": "https://referencesource.org/state-marketplace-assistance-programs/maine/",
"source": "https://www.coverme.gov/learn/how-to-enroll/open-enrollment",
"source_quote": "Open Enrollment is an event that happens every year from November 1 through January 15. During Open Enrollment, Maine residents can get or change private health and dental insurance plans that meet Affordable Care Act standards.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Maryland",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Maryland Health Connection",
"marketplace_url": "https://www.marylandhealthconnection.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "Maryland Premium Assistance",
"state_premium_income_range": "up to 400% federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "Maryland residents of any age with incomes up to 400% federal poverty level may be able to receive help paying for their monthly health insurance costs thanks to a new state program",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "maryland",
"url": "https://referencesource.org/state-marketplace-assistance-programs/maryland/",
"source": "https://www.marylandhealthconnection.gov/maryland-premium-assistance/",
"source_quote": "Maryland Premium Assistance - Maryland Health Connection and tags on every page of your site. --> Changes are coming to your health insurance. Here\u2019s what you need to know .",
"verified_fields": [
"marketplace_name",
"marketplace_url",
"state",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Massachusetts",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Massachusetts Health Connector",
"marketplace_url": "https://www.mahealthconnector.org/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "ConnectorCare",
"state_premium_income_range": "100% to 400% of the federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "ConnectorCare plans have $0 or low monthly premiums, low out-of-pocket costs, and no deductibles",
"state_cost_sharing_program": "ConnectorCare",
"basic_health_program": "none",
"individual_mandate": "yes",
"id": "massachusetts",
"url": "https://referencesource.org/state-marketplace-assistance-programs/massachusetts/",
"source": "https://www.mahealthconnector.org/wp-content/uploads/ConnectorCare-Overview-2026.pdf",
"source_quote": "People with household incomes that are between 100% and 400% of the Federal Poverty Level (FPL) may qualify for ConnectorCare",
"verified_fields": [
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Michigan",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "michigan",
"url": "https://referencesource.org/state-marketplace-assistance-programs/michigan/",
"source": "https://www.healthinsurance.org/michigan/",
"source_quote": "The next open enrollment period, for coverage effective in 2027, is expecte to run from November 1, 2026 to January 15, 2027 (the >https://www.healthinsurance.org/blog/new-federal-rule-brings-immediate-changes-to-marketplace-enrollment/#2027< federal rule change requiring a shorter open enrollment period was vacated by a judge in June 2026). 8 Where do I enroll in a Marketplace plan in Michigan? Michigan residents use >https://www.healthcare.gov/< HealthCare.gov to enroll in individual and family health plans.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Minnesota",
"marketplace_type": "State-based marketplace",
"marketplace_name": "MNsure",
"marketplace_url": "https://www.mnsure.org/",
"medicaid_expansion": "yes",
"ptc_income_floor": "200% of the federal poverty level (MinnesotaCare BHP covers 138% to 200% FPL; premium tax credit eligibility begins above 200% FPL)",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "MinnesotaCare",
"individual_mandate": "no",
"open_enrollment_start": "2026-11-01",
"open_enrollment_end": "2026-12-31",
"open_enrollment_year": "2027",
"id": "minnesota",
"url": "https://referencesource.org/state-marketplace-assistance-programs/minnesota/",
"source": "https://www.healthinsurance.org/minnesota/",
"source_quote": "Not be eligible for Medical Assistance (Minnesota Medicaid) or MinnesotaCare. Not be eligible for premium-free Medicare Part A. 4 If married, file a joint tax return with your spouse. 5 (with very limited exceptions) 6 Not be able to be claimed by someone else as a tax dependent. 5 When can I enroll in an ACA-compliant plan in Minnesota? In Minnesota, the >https://www.mnsure.org/new-customers/enrollment-deadlines/open-enrollment/index.jsp< open enrollment period for a 2027 ACA-compliant individual or family health plan is currently scheduled to run from November 1, 2026, to December 31, 2026. 7 This is shorter than the enrollment window that was used for the last several years, due to a federal rule change requiring open enrollment >https://www.healthinsurance.org/blog/new-federal-rule-brings-immediate-changes-to-marketplace-enrollment/#2027< to end no later than December 31 .",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Mississippi",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "mississippi",
"url": "https://referencesource.org/state-marketplace-assistance-programs/mississippi/",
"source": "https://www.healthinsurance.org/mississippi/",
"source_quote": "8 When can I enroll in an ACA-compliant plan in Mississippi? The >https://www.healthcare.gov/quick-guide/dates-and-deadlines/< open enrollment period to sign up for 2027 ACA-compliant individual and family health plans is expected to run from November 1, 2026 through January 15, 2027 in Mississippi.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Missouri",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "missouri",
"url": "https://referencesource.org/state-marketplace-assistance-programs/missouri/",
"source": "https://www.healthinsurance.org/missouri/",
"source_quote": "Missouri uses the federally-facilitated health insurance Marketplace, HealthCare.gov. The Marketplace website will let you shop for health plans offered by several private insurance companies (plan availability varies from one area of the state to another).",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Montana",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "December 15, 2026",
"open_enrollment_year": "2027",
"id": "montana",
"url": "https://referencesource.org/state-marketplace-assistance-programs/montana/",
"source": "https://www.healthinsurance.org/montana/",
"source_quote": "Montana uses the federally-facilitated Marketplace, which is >https://www.healthcare.gov/< HealthCare.gov . Three private insurance companies offer coverage in the Montana Health Insurance Marketplace in 2026,",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Nebraska",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "December 15, 2026",
"open_enrollment_year": "2027",
"id": "nebraska",
"url": "https://referencesource.org/state-marketplace-assistance-programs/nebraska/",
"source": "https://www.healthinsurance.org/nebraska/",
"source_quote": "Nebraska uses the federally-facilitated health insurance Marketplace (exchange), >https://www.healthcare.gov/< HealthCare.gov , where residents can purchase individual or family health insurance coverage .",
"verified_fields": [
"basic_health_program",
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],
"derived_fields": [
"coverage_gap",
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]
},
{
"state": "Nevada",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Nevada Health Link",
"marketplace_url": "https://www.nevadahealthlink.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "nevada",
"url": "https://referencesource.org/state-marketplace-assistance-programs/nevada/",
"source": "https://www.nevadahealthlink.com/",
"source_quote": "Nevada Health Link",
"verified_fields": [
"marketplace_name",
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],
"derived_fields": [
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},
{
"state": "New Hampshire",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "new-hampshire",
"url": "https://referencesource.org/state-marketplace-assistance-programs/new-hampshire/",
"source": "https://www.healthinsurance.org/new-hampshire/",
"source_quote": "New Hampshire did not create a state-based exchange, so New Hampshire\u2019s Marketplace is the federally-facilitated >https://www.healthcare.gov/< HealthCare.gov . A New Hampshire Marketplace plan can be a great coverage option if you aren\u2019t eligible for Medicare or Medicaid, and also don’t have an offer of affordable health insurance from your employer. Depending on your household income and circumstances, you may be eligible for financial assistance when you enroll in health coverage through the New Hampshire Marketplace. Four private health insurance companies offer individual/family coverage through New Hampshire’s Marketplace for 2026 1 but one is leaving at the end of 2026. (See below for details about premium and insurer changes for 2027.) Starting in 2026, New Hampshire prohibits ground ambulance providers from balance billing patients for amounts above their health plan’s regular in-network cost-sharing (deductible, coinsurance, or copays). 2 This is important, as the federal No",
"verified_fields": [
"basic_health_program",
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"derived_fields": [
"coverage_gap",
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]
},
{
"state": "New Jersey",
"marketplace_type": "State-based marketplace",
"marketplace_name": "GetCoveredNJ",
"marketplace_url": "https://www.nj.gov/getcoverednj/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "New Jersey Health Plan Savings",
"state_premium_income_range": "up to 600% of the federal poverty level",
"state_assistance_above_400": "yes",
"state_premium_amount": "Tax households with annual incomes up to 600% of the federal poverty level will receive NJHPS. An individual with an income of up to $93,900 and a family of four who makes up to $192,900 can receive state subsidies to lower the costs of health coverage.",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "yes",
"id": "new-jersey",
"url": "https://referencesource.org/state-marketplace-assistance-programs/new-jersey/",
"source": "https://www.nj.gov/getcoverednj/financialhelp/premiums/",
"source_quote": "Tax households with annual incomes up to 600% of the federal poverty level will receive NJHPS",
"verified_fields": [
"state_premium_income_range"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
],
"also_reported": [
{
"field": "open_enrollment_start",
"value": "2025-11-01",
"source": "https://nj.gov/getcoverednj/",
"source_quote": "New Jersey. Learn more Find local assistance at no cost to you. Previous Next acerca de --> Federal Financial Help Changes for Plan Year 2026 New federal changes are impacting how much consumers will pay for coverage in 2026.",
"as_of": "2026-08-14"
},
{
"field": "open_enrollment_end",
"value": "2026-01-31",
"source": "https://nj.gov/getcoverednj/",
"source_quote": "New Jersey. Learn more Find local assistance at no cost to you. Previous Next acerca de --> Federal Financial Help Changes for Plan Year 2026 New federal changes are impacting how much consumers will pay for coverage in 2026.",
"as_of": "2026-08-14"
},
{
"field": "open_enrollment_year",
"value": "2026",
"source": "https://nj.gov/getcoverednj/",
"source_quote": "New Jersey. Learn more Find local assistance at no cost to you. Previous Next acerca de --> Federal Financial Help Changes for Plan Year 2026 New federal changes are impacting how much consumers will pay for coverage in 2026.",
"as_of": "2026-08-14"
}
],
"disagreements": []
},
{
"state": "New Mexico",
"marketplace_type": "State-based marketplace",
"marketplace_name": "BeWell, New Mexico's Health Insurance Marketplace",
"marketplace_url": "https://bewellnm.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "New Mexico Premium Assistance",
"state_premium_income_range": "all income levels, including above 400% of the federal poverty level",
"state_assistance_above_400": "yes",
"state_premium_amount": "backfills the full loss of the enhanced federal credit, meaning no disruptions in coverage or cliffs for financial assistance",
"state_cost_sharing_program": "State Out-of-Pocket Assistance (SOPA)",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "new-mexico",
"url": "https://referencesource.org/state-marketplace-assistance-programs/new-mexico/",
"source": "https://bewellnm.com/answers/federal-changes/",
"source_quote": "meaning no disruptions in coverage or \u201ccliffs\u201d for financial assistance. The state budget also commits funding for lawfully present noncitizens who will lose Medicaid this fall as a result of their citizenship status. BeWell and the Health Care Authority will share more details about this assistance soon. House Bill 4, sponsored by Representative Reena Szczepanski, will phase in higher amounts of revenue from the Health Insurance Premium Surtax to the Health Care Affordability Fund by 2029. This means there will be resources in the fund to continue state subsidies and keep marketplace coverage affordable for years to come! October 2025 changes During an October special legislative session called by Governor Michelle Lujan Grisham, New Mexico lawmakers passed the following legislation for a 6-month temporary fix. The 2026 legislative session begins in January and we expect lawmakers will be discussing subsidies and possible extensions. If you are getting federal subsidies now, and they are set to expire in 2025, you will have your savings covered by the State of New Mexico. Connect with a certified assister who can answer your questions for free. Allows New Mexicans with incomes over 400% of the federal poverty level (FPL) to receive New Mexico Premium Assistance to backfill the loss of enhanced premium tax credits (EPTC) if the federal credits expire at the end of the year.",
"verified_fields": [
"individual_mandate",
"marketplace_url",
"state",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "New York",
"marketplace_type": "State-based marketplace",
"marketplace_name": "NY State of Health",
"marketplace_url": "https://nystateofhealth.ny.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "Silver Supreme and Silver Enhanced cost-sharing reduction plans",
"basic_health_program": "Essential Plan",
"individual_mandate": "no",
"id": "new-york",
"url": "https://referencesource.org/state-marketplace-assistance-programs/new-york/",
"source": "https://info.nystateofhealth.ny.gov/EssentialPlan",
"source_quote": "NY State of Health's Essential Plan includes comprehensive benefits with $0 monthly premiums and very low-cost sharing",
"verified_fields": [
"basic_health_program",
"marketplace_name"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
],
"disagreements": [
{
"field": "state_cost_sharing_program",
"versions": [
{
"value": "Silver Supreme and Silver Enhanced cost-sharing reduction plans",
"source": "https://info.nystateofhealth.ny.gov/EssentialPlan",
"source_quote": "NY State of Health's Essential Plan includes comprehensive benefits with $0 monthly premiums and very low-cost sharing",
"as_of": "2026-08-14"
},
{
"value": "Silver Supreme and Silver Enhanced cost-sharing reductions",
"source": "https://info.nystateofhealth.ny.gov/costsavings",
"source_quote": "Expanded eligibility for Silver Supreme CSR plans: Consumers with incomes up to 350% of the Federal Poverty Level (FPL) are now eligible for this plan",
"as_of": "2026-08-14"
}
]
}
]
},
{
"state": "North Carolina",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "December 15, 2026",
"open_enrollment_year": "2027",
"id": "north-carolina",
"url": "https://referencesource.org/state-marketplace-assistance-programs/north-carolina/",
"source": "https://www.healthinsurance.org/north-carolina/",
"source_quote": "North Carolina uses the federally facilitated health insurance exchange platform \u2014 Healthcare.gov \u2014 for residents to purchase its >https://www.healthinsurance.org/aca-marketplace/< ACA Marketplace plans .",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "North Dakota",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "north-dakota",
"url": "https://referencesource.org/state-marketplace-assistance-programs/north-dakota/",
"source": "https://www.healthinsurance.org/north-dakota/",
"source_quote": "In North Dakota, you can sign up for ACA Marketplace coverage through >https://www.healthcare.gov/< HealthCare.gov , as North Dakota uses the federally-facilitated Marketplace.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Ohio",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "December 15, 2026",
"open_enrollment_year": "2027",
"id": "ohio",
"url": "https://referencesource.org/state-marketplace-assistance-programs/ohio/",
"source": "https://www.healthinsurance.org/ohio/",
"source_quote": "People in Ohio use HealthCare.gov to enroll in ACA Marketplace plans. These plans are a good option for people who are not eligible for Medicare, Medicaid, or employer-sponsored coverage.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Oklahoma",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "oklahoma",
"url": "https://referencesource.org/state-marketplace-assistance-programs/oklahoma/",
"source": "https://www.healthinsurance.org/oklahoma/",
"source_quote": "As of May 2026, Oklahoma has a state-run Marketplace that uses the federally-run >https://www.healthcare.gov/< Healthcare.gov enrollment platform. 1 But from a consumer perspective, little changed in May 2026, as Oklahoma residents already used HealthCare.gov to enroll in coverage",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Oregon",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Oregon's Health Insurance Marketplace",
"marketplace_url": "https://healthcare.oregon.gov/Pages/index.aspx",
"medicaid_expansion": "yes",
"ptc_income_floor": "200% of the federal poverty level (OHP Bridge BHP covers 138% to 200% FPL; premium tax credit eligibility begins above 200% FPL)",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "OHP Bridge",
"individual_mandate": "no",
"open_enrollment_start": "2026-11-01",
"open_enrollment_end": "2026-12-31",
"open_enrollment_year": "2027",
"id": "oregon",
"url": "https://referencesource.org/state-marketplace-assistance-programs/oregon/",
"source": "https://www.healthinsurance.org/oregon/",
"source_quote": "And for 2027, the insurers remaining in Oregon’s Marketplace have proposed a weighted average rate increase of 17.5% (details below). 3 In July 2024, Oregon started operating a >https://www.healthinsurance.org/obamacare/affordable-care-acts-basic-health-program/< Basic Health Program , known as Oregon Health Plan (OHP) Bridge. Coverage under this program is available to adults under age 65 whose household income is between 138% and 200% of the federal poverty level. 4 Oregon operates a state-based health insurance Marketplace but uses the HealthCare.gov enrollment platform (ie, an SBE-FP). 5 That will change as of the fall of 2026, however, when Oregon will start running its own Marketplace platform, under the terms of legislation (SB972) the state enacted in 2023. 6 (Oregon had a fully state-based exchange in 2014, but the website didn’t work well and the state opted to switch to an SBE-FP starting in the fall of 2014. 7 The state plans to transition back to an SBE in the fall of 2026.) For now, you can visit >https://healthcare.oregon.gov/Pages/index.aspx< OregonHealthCare.gov to gather information about health insurance plans, eligibility, and more. 8 When you’re ready to apply and enroll, you’ll be directed to HealthCare.gov to complete the enrollment (but starting in November 2026, this will no longer be the case, as Oregon will stop using the HealthCare.gov platform). Enrollment in OHP Bridge is done via >https://one.oregon.gov/< one.Oregon.gov .",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Pennsylvania",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Pennie",
"marketplace_url": "https://www.pennie.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "pennsylvania",
"url": "https://referencesource.org/state-marketplace-assistance-programs/pennsylvania/",
"source": "https://www.pennie.com/",
"source_quote": " Do you need assistance in your language? (PDF) The trademarks, logos, and service marks (collectively referred to as “Trademarks”) displayed on this website are property of the Pennsylvania Health Insurance Exchange Authority and no trademark license either express or implied is granted by thereby.",
"verified_fields": [
"individual_mandate",
"marketplace_name",
"state",
"state_assistance_above_400"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Rhode Island",
"marketplace_type": "State-based marketplace",
"marketplace_name": "HealthSource RI",
"marketplace_url": "https://www.healthsourceri.com/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "yes",
"id": "rhode-island",
"url": "https://referencesource.org/state-marketplace-assistance-programs/rhode-island/",
"source": "https://www.healthsourceri.com/",
"source_quote": "HealthSource RI",
"verified_fields": [
"marketplace_name"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "South Carolina",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "south-carolina",
"url": "https://referencesource.org/state-marketplace-assistance-programs/south-carolina/",
"source": "https://www.healthinsurance.org/south-carolina/",
"source_quote": "Visit >https://www.healthcare.gov/< Healthcare.gov to access South Carolina’s health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans. Contact the HealthCare.gov call center at 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, 7 days a week (closed on holidays). Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator, or a certified application counselor. Enroll via an approved enhanced direct enrollment entity. 9 How can I find affordable health insurance in South Carolina? South Carolina uses the federally-facilitated exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov. During the open enrollment period for 2026 coverage, more than 89% of enrollees qualified for premium subsidies, amounting to an average savings of $579/month. After the subsidies (premium tax credits) were applied, the average enrollee\u2019s monthly cost was about $76/month 10 Premium subsidies are still available in 2026, but they don’t cover as much of total premiums as they did in 2025, and they are >https://www.healthinsurance.org/blog/marketplace-enrollees-face-return-of-the-subsidy-cliff/< no longer available to households with income above 400% of the federal poverty level.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "South Dakota",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "south-dakota",
"url": "https://referencesource.org/state-marketplace-assistance-programs/south-dakota/",
"source": "https://www.healthinsurance.org/south-dakota/",
"source_quote": "South Dakota uses the federally-facilitated >https://www.healthcare.gov/< HealthCare.gov exchange platform for residents to purchase its ACA Marketplace plans.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Tennessee",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "tennessee",
"url": "https://referencesource.org/state-marketplace-assistance-programs/tennessee/",
"source": "https://www.healthinsurance.org/tennessee/",
"source_quote": "Visit >https://www.healthcare.gov/< HealthCare.gov to access Tennessee’s health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans. Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity. 10 You can also call HealthCare.gov\u2019s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it\u2019s closed on holidays. How can I find affordable health insurance in Tennessee? Tennessee uses the federally facilitated exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov. Ninety percent of the people who purchased health plans through the Tennessee Marketplace during the open enrollment period for 2026 coverage were eligible for advance premium tax credits (APTC), also known as premium subsidies. The APTC amounted to an average savings of $772/month and reduced the average subsidy-eligible enrollee\u2019s premium to about $67/month. 11 But because Congress didn’t extend the federal subsidy enhancements that expired at the end of 2025, subsidies are >https://www.healthinsurance.org/blog/marketplace-enrollees-face-return-of-the-subsidy-cliff/< no",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Texas",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "texas",
"url": "https://referencesource.org/state-marketplace-assistance-programs/texas/",
"source": "https://www.healthinsurance.org/texas/",
"source_quote": ">https://www.healthcare.gov/see-plans/#/< See Plans & Prices ” (zip codes 79252, 79248, 76384, 76380, 76310, 76308, 76305) HealthCare.gov. Accessed Dec. 28, 2025 ⤶ ” >https://ratereview.healthcare.gov/< Texas Rate Review Submissions ” RateReview. HealthCare.gov. Accessed Dec. 28, 2025 ⤶ ” >https://acasignups.net/rate_changes/2026/tx< 2026 Final Gross Rate Changes – Texas: +34.7% (updated) ” ACA Signups. Nov. 2, 2025 ⤶ ” >https://ratereview.healthcare.gov/< Texas Rate Review Submissions ” RateReview. HealthCare.gov. Accessed Dec. 4, 2025 ⤶ >https://www.tdi.texas.gov/health/ratereview.html< Texas Rate Review Requirements for Health Benefit Plans . Texas Department of Insurance. Accessed December 2023. ⤶ >https://www.commonwealthfund.org/blog/2014/analysis-finds-no-nationwide-increase-health-insurance-marketplace-premiums?redirect_source=/publications/blog/2014/dec/zero-inflation-nationwide-for-marketplace-premiums<",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Utah",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "2026-11-01",
"open_enrollment_end": "2027-01-15",
"open_enrollment_year": "2027",
"id": "utah",
"url": "https://referencesource.org/state-marketplace-assistance-programs/utah/",
"source": "https://www.healthinsurance.org/utah/",
"source_quote": "In Utah, the exchange (Marketplace) is operated by the federal government, meaning individuals and families enroll in health plans through HealthCare.gov or authorized enhanced direct enrollment entities. 1 For 2026, six insurers offer Marketplace coverage in Utah, with varying coverage areas, 2 and all six plan to continue to offer coverage in 2027",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Vermont",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Vermont Health Connect",
"marketplace_url": "https://vermonthealthconnect.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "Vermont Premium Assistance",
"state_premium_income_range": "up to 300% of the federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "VPA lowers your monthly health insurance bill by 1.5% of your household income",
"state_cost_sharing_program": "Enhanced Silver plans",
"basic_health_program": "none",
"individual_mandate": "yes",
"individual_mandate_penalty": "Vermont requires reporting but imposes no financial penalty",
"id": "vermont",
"url": "https://referencesource.org/state-marketplace-assistance-programs/vermont/",
"source": "https://info.healthconnect.vermont.gov/learn-more/financial-help",
"source_quote": "Vermont Premium Assistance (VPA) is money from the State of Vermont that lowers your monthly health insurance bill",
"verified_fields": [
"state",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Virginia",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Virginia's Insurance Marketplace",
"marketplace_url": "https://www.marketplace.virginia.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "Virginia Premium Savings",
"state_premium_income_range": "138% to 250% of the federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "state subsidies funded through the Virginia Health Insurance Affordability Fund, created by the Virginia General Assembly in a 2026 special session; amount per enrollee not stated on this page",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "2026-11-01",
"open_enrollment_end": "2027-01-29",
"open_enrollment_year": "2027",
"id": "virginia",
"url": "https://referencesource.org/state-marketplace-assistance-programs/virginia/",
"source": "https://www.marketplace.virginia.gov/federalchanges",
"source_quote": "Pregnant non-citizens can get coverage if they have qualifying incomes, no matter their immigration status. For more information: Information for Noncitizens Shorter Open Enrollment (effective Nov 1, 2026) Open Enrollment will begin November 1, 2026, and will end on January 29, 2027. Non-Citizen Eligibility Changes \u2013 Part 3 (effective January 1, 2027) Changes to noncitizen eligibility for federal Marketplace tax credits (APTC/PTC) and cost sharing reductions (CSRs) will start on January 1, 2027. Starting with Plan Year 2027 Open Enrollment, only U.S. citizens, U.S. nationals, and non-citizens with these status types can get APTC and CSR: Lawful Permanent Residents (LPRs/green card holders) Cuban/Haitian Entrants COFA Migrants Other types of non-citizens won't qualify for the Advance Premium Tax Credit (APTC). These consumers will be renewed for plan year 2027, but without a tax credit. All current \u201clawfully present\u201d statuses can still get Marketplace QHP coverage and may qualify for additional Virginia Premium Savings to reduce their monthly costs.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_amount",
"state_premium_income_range",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Washington",
"marketplace_type": "State-based marketplace",
"marketplace_name": "Washington Healthplanfinder",
"marketplace_url": "https://www.wahealthplanfinder.org/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "Cascade Care Savings",
"state_premium_income_range": "up to 250% of the federal poverty level",
"state_assistance_above_400": "no",
"state_premium_amount": "Customers with federal subsidies: $55 per member, per month (PMPM). Customers without federal subsidies: $250 PMPM",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"id": "washington",
"url": "https://referencesource.org/state-marketplace-assistance-programs/washington/",
"source": "https://www.wahbexchange.org/content/dam/materials/communications/legislative/2025/WAHBE_Final_PY_2026_Cascade_Care_Savings_Maximum_Per_Member_Per_Month_Methodology.pdf",
"source_quote": "Customers with federal subsidies: $55 per member, per month (PMPM)",
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
],
"disagreements": [
{
"field": "state_premium_income_range",
"versions": [
{
"value": "up to 250% of the federal poverty level",
"source": "https://www.wahbexchange.org/content/dam/materials/communications/legislative/2025/WAHBE_Final_PY_2026_Cascade_Care_Savings_Maximum_Per_Member_Per_Month_Methodology.pdf",
"source_quote": "Customers with federal subsidies: $55 per member, per month (PMPM)",
"as_of": "2026-08-14"
},
{
"value": "at or below 250% of the federal poverty level",
"source": "https://www.wahbexchange.org/about-the-exchange/initiatives/cascade-care/cascade-care-savings/",
"source_quote": "The Exchange finalized the two fixed-dollar maximum per-enrollee Cascade Care Savings amount for plan year 2026 as $55 per member per month (PMPM) for members receiving federal subsidies and $250 PMPM for members not receiving federal subsidies",
"as_of": "2026-08-14"
}
]
},
{
"field": "state_premium_amount",
"versions": [
{
"value": "Customers with federal subsidies: $55 per member, per month (PMPM). Customers without federal subsidies: $250 PMPM",
"source": "https://www.wahbexchange.org/content/dam/materials/communications/legislative/2025/WAHBE_Final_PY_2026_Cascade_Care_Savings_Maximum_Per_Member_Per_Month_Methodology.pdf",
"source_quote": "Customers with federal subsidies: $55 per member, per month (PMPM)",
"as_of": "2026-08-14"
},
{
"value": "$55 per member per month (PMPM) for members receiving federal subsidies and $250 PMPM for members not receiving federal subsidies",
"source": "https://www.wahbexchange.org/about-the-exchange/initiatives/cascade-care/cascade-care-savings/",
"source_quote": "The Exchange finalized the two fixed-dollar maximum per-enrollee Cascade Care Savings amount for plan year 2026 as $55 per member per month (PMPM) for members receiving federal subsidies and $250 PMPM for members not receiving federal subsidies",
"as_of": "2026-08-14"
}
]
}
]
},
{
"state": "West Virginia",
"marketplace_type": "Federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "yes",
"ptc_income_floor": "138% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1, 2026",
"open_enrollment_end": "January 15, 2027",
"open_enrollment_year": "2027",
"id": "west-virginia",
"url": "https://referencesource.org/state-marketplace-assistance-programs/west-virginia/",
"source": "https://www.healthinsurance.org/west-virginia/",
"source_quote": "West Virginia uses the federally run HealthCare.gov health insurance Marketplace. You can use the West Virginia Health Insurance Marketplace to enroll in health coverage for yourself or your family.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Wisconsin",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "no",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "wisconsin",
"url": "https://referencesource.org/state-marketplace-assistance-programs/wisconsin/",
"source": "https://www.healthinsurance.org/wisconsin/",
"source_quote": ">https://ratereview.healthcare.gov/< RateReview.HealthCare.gov . Accessed Sep. 21, 2025 ⤶ ” >https://acasignups.net/rate_changes/2026/wi< 2026 Final Gross Rate Changes – Wisconsin: +22.8%; multiple carriers pulling out of multiple counties ” ACA Signups. Oct. 28, 2025 ⤶ ” >https://www.cms.gov/files/document/effectuated-enrollment-early-snapshot-2025-and-full-year-2024-average.pdf< Effectuated Enrollment: Early 2025 Snapshot and Full Year 2024 Average ” CMS.gov, July 24, 2025 ⤶ >https://www.commonwealthfund.org/blog/2014/analysis-finds-no-nationwide-increase-health-insurance-marketplace-premiums?redirect_source=/publications/blog/2014/dec/zero-inflation-nationwide-for-marketplace-premiums< Analysis Finds No Nationwide Increase in Health Insurance Marketplace Premiums . The Commonwealth Fund. December 2014. ⤶ >https://acasignups.net/15/10/29/final-projection-2016-weighted-avg-rate-increases-12-13-nationally< FINAL PROJECTION: 2016 Weighted Avg. Rate Increases: 12-13% Nationally* ACA Signups. October 2015. ⤶ >https://acasignups.net/rate-hikes/2017< Avg. UNSUBSIDIZED Indy Mkt Rate Hikes: 25% (49 States + DC) . ACA Signups. October 2016. ⤶ >https://oci.wi.gov/Pages/PressReleases/20171012OpenEnrollment.aspx< Press Release, October 12, 2017, 2018 Open Enrollment: November 1 \u2013",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
},
{
"state": "Wyoming",
"marketplace_type": "federally-facilitated marketplace",
"marketplace_name": "HealthCare.gov",
"marketplace_url": "https://www.healthcare.gov/",
"medicaid_expansion": "no",
"ptc_income_floor": "100% of the federal poverty line",
"coverage_gap": "yes",
"state_premium_program": "none",
"state_assistance_above_400": "no",
"state_cost_sharing_program": "none",
"basic_health_program": "none",
"individual_mandate": "no",
"open_enrollment_start": "November 1",
"open_enrollment_end": "January 15",
"open_enrollment_year": "2026",
"id": "wyoming",
"url": "https://referencesource.org/state-marketplace-assistance-programs/wyoming/",
"source": "https://www.healthinsurance.org/wyoming/",
"source_quote": "7 When can I enroll in an ACA-compliant plan in Wyoming? In Wyoming, the >https://www.healthcare.gov/quick-guide/dates-and-deadlines/< open enrollment period to sign up for 2027 ACA-compliant individual and family health plans is expected to run from November 1, 2026 through January 15, 2027.",
"verified_fields": [
"basic_health_program",
"individual_mandate",
"marketplace_name",
"marketplace_type",
"marketplace_url",
"medicaid_expansion",
"open_enrollment_end",
"open_enrollment_start",
"open_enrollment_year",
"state",
"state_assistance_above_400",
"state_cost_sharing_program",
"state_premium_program"
],
"derived_fields": [
"coverage_gap",
"ptc_income_floor"
]
}
]
}