Marketplace (Qualified Health Plans)

Individual and small-group (SHOP) qualified health plans available on the Federally-Facilitated Marketplace for plan year 2026, published by CMS in the PY2026 QHP Landscape files. dim_qhp_plan holds one row per plan; fct_qhp_premiums unrolls the CMS rating template into plan × county × household-scenario premium quotes; fct_qhp_cost_sharing holds the deductible / MOOP grid alongside each plan's silver cost-sharing-reduction (CSR) variants. All page views read a pre-aggregated source query — the ~5.4 M premium rows never leave the warehouse.

Framing caveat: FFM only, not national

This page covers only the 30 states that use HealthCare.gov — the Federally-Facilitated Marketplace plus the state-partnership marketplaces. State-based exchanges (including California, Colorado, Connecticut, DC, Georgia, Idaho, Illinois, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Washington) run their own plan-shopping platforms and are absent from the CMS landscape files. Any state-level statistic below is a partial picture of the U.S. individual market.

The SHOP (small-group) landscape in this vintage is nearly empty —

Benchmark silver premiums by state

The lowest-cost silver plan in each county is the anchor for premium-tax-credit calculations under the ACA — enrollee subsidies grow so that a household pays at most a fixed share of income for that plan. The chart below averages that lowest-silver monthly premium across counties in each state for a 40-year-old buying an individual policy.

The spread is wide even inside the FFM footprint: New Hampshire's average lowest-cost silver runs about $400/month; Wyoming's is nearly triple that. Alaska, Wyoming, and West Virginia are the three consistently most-expensive FFM states across all metal tiers.

County-level spread

Each point is one county's lowest-cost silver premium (age 40, individual). Within-state variation is the geographic-rating-area signal — Texas alone spans more than $400 between its cheapest and most-expensive lowest-silver counties.

Premium spread by metal level

Metal levels reflect actuarial value: Bronze / Expanded Bronze plans cover ~60% of expected medical costs, Silver ~70%, Gold ~80%, Platinum ~90%. Catastrophic plans are limited to enrollees under 30 or with a hardship exemption and carry the lowest premiums but no premium-tax-credit eligibility. The IQR bars below show 25th–75th percentile monthly premium at age 40 across every county-plan offering in the FFM.

The Gold–Silver gap is small in this vintage — the median gold plan runs only about 4% above the median silver ($774 vs $745) — a pattern that reflects "silver loading" (the practice of concentrating the cost of the unfunded CSR benefit into silver premiums). Expanded Bronze plans, which allow one additional service before the deductible, sit noticeably above plain Bronze.

Issuer concentration

Herfindahl-Hirschman Index (HHI) computed over each issuer's share of individual-medical plan-county offerings in the state (age-40 individual scenario used as the enumeration basis so every plan counts once per county in which it is sold). HHI values are on the standard 0–10,000 scale where the U.S. Department of Justice guidelines call anything above 2,500 "highly concentrated" and above 1,800 "moderately concentrated." Note this is a plan-availability HHI, not an enrollment-share HHI — CMS does not publish plan-level enrollment counts in the landscape file.

Every FFM state is at least "moderately concentrated." Alaska, West Virginia, Hawaii, and Wyoming operate with just two individual-medical issuers apiece. Four states field more than ten competing carriers — Texas and Florida (15 each), Wisconsin (12), and Ohio (11). A deep issuer bench does not by itself buy cheap silver: Ohio pairs its 11 carriers with one of the lowest benchmark silver premiums in the table above, while Texas and Florida sit among the most expensive silver markets despite leading the issuer count.

The CSR deductible cliff

Silver plans on the FFM come in four flavours: a standard silver plan and three cost-sharing-reduction (CSR) variants offered to enrollees whose household income falls below 250% of the federal poverty level. The variants leave the premium untouched but slash the deductible and out-of-pocket maximum — the discontinuity between the "73%" variant (200–250% FPL) and the standard silver plan is the cliff households face when income rises past the 250% threshold.

The 94% CSR variant (100–150% FPL) has a median deductible of $0 and the median 87% variant plan is $700 — jumping to $3,000 at the 73% variant and $6,000 at standard silver. A household that gains enough income to cross from 200% to 250% FPL is auto-enrolled into a plan whose deductible is roughly double, without any change to the plan they've chosen or the premium they pay before subsidies.

Child and dental coverage

Child-only enrollment

Every individual-market medical plan on the FFM allows child-only enrollment. Dental issuers split between plans that accept both adults and children and a smaller pool of dedicated child-only dental plans.

Dental premiums

Stand-alone dental plans come in two actuarial tiers on the FFM. High plans cover a larger share of expected costs (roughly 85% AV in the CMS template) at a higher premium; Low plans cover less (roughly 70% AV). Child dental is an essential health benefit under the ACA, and pediatric dental is embedded in nearly every FFM medical plan — the stand-alone dental market shown here layers on top of that.

The tier gap is real: median child dental runs about $37/month at the High tier vs $26 at Low, and adult dental medians land at $33 and $18 respectively. Neither is subsidised through premium tax credits.

Caveats

• FFM only. The 30 states covered here are the ones that use HealthCare.gov. Roughly a third of the U.S. individual-market population enrols through a state-based exchange that publishes its own landscape file, and those enrollees, plans, and issuers are entirely absent.
• List prices, not paid prices. Every premium above is the plan's gross monthly premium. Roughly 90% of FFM enrollees receive advance premium tax credits that reduce what they actually pay; that subsidy math depends on household income and the benchmark silver premium in their county and is not applied here.
• Point-in-time landscape. All figures reflect the CMS landscape file as_of August 26, 2026 . Issuers can file rate revisions through open enrolment, and plan availability can change between now and coverage effective date.
• Plan-availability concentration. The HHI reported above weights each plan-county offering equally; it is not an enrollment-share concentration measure. CMS does not publish plan-level enrolment counts in the landscape data, so a true market-share HHI would require the SBM-and-FFM combined effectuated-enrolment PUF.
• SHOP nearly empty. Small-group SHOP plans exist for only four states in the medical file (AL, MT, NH, WI) and one on the dental side (WI). SHOP is excluded from every state chart above; the SHOP totals in the headline are for reference only.
• CSR variants apply only to silver plans. The cost-sharing tiers in the CSR-deductible section exist only in the silver metal band; bronze, gold, and platinum plans carry only the standard cost-sharing structure regardless of enrolee income.