ACA Health Insurance: Prevalence, Premiums and Subsidies by State – 2025 Study

The Affordable Care Act, ACA – commonly known as Obamacare – offers federally backed health insurance for millions of Americans. Certain tax credits act as monthly premium subsidies for the insured, generally bringing the costs down by thousands of dollars per year. However, the funding for these subsidies are set to expire at the end of 2025, and Congress must now decide whether or not to extend the program. If the program does not get funded, up to 20% of Americans in each state could owe thousands more per year in health insurance premiums.

With this in mind, SmartAsset ranked 50 states based on the prevalence of ACA plans among residents, the average monthly premiums they currently pay, and the subsidies that are at stake.

Key Findings

• 20% of Floridians rely on ACA healthcare plans. Florida is most reliant on government-supported health insurance with 20.3% of the population enrolled in a plan in 2025, or over 4.735 million people. The average premium before tax credits is $641, but individuals generally only pay $67 per month out of pocket after subsidies. Georgia has the second-highest reliance on ACA plans, with 13.5% of the population participating, receiving an average $546 monthly credit for an average individual premium payment of $74.
• These states receive the largest subsidies for health insurance. West Virginia residents are subsidized at an average of $1,069 per month. Post credits, the individual pays an average monthly premium of $101. However, only 3.8% of the population participates in ACA plans. Alaska ($882); Wyoming ($872); Vermont ($847); and Connecticut ($605) also have among the largest monthly average subsidies. 
• Mississippi residents pay only $41 per month for ACA health insurance. On average, Mississippi beneficiaries have the lowest monthly premium bill. But the real cost of each plan pre-credits is $605, yielding an average monthly subsidy of $564 per person. Texas has the second lowest average individual monthly premium paid at $57 after a $516 credit, followed by Alabama at $65 per month after a $584 credit.
• New Yorkers have the most expensive ACA plans – and use them least. Only 1.1% of the New York population is enrolled in a federal healthcare plan, the lowest nationwide. Individuals also have the highest average monthly premium payment at $532. The average credit is smallest nationwide relative to total plan cost, with an average of $259 in monthly subsidy.
• Children are most reliant on ACA plans in Utah. 12.6% of the population under age 18 in Utah is enrolled in an ACA healthcare plan, with an average individual monthly premium of $70. Child enrollment actually slightly exceeds general population enrollment, which clocked at 12.0%. The average monthly premium credit in Utah is $444.

States by ACA Coverage, Premiums, and Subsidies

1. Florida

• Percent of population enrolled in ACA plans: 20.26%
• Number of ACA enrollees: 4735415
• Average monthly premium paid by individual: $67
• Average monthly premium credit at stake: $574
• Average monthly cost of plan: $641
• Percent of children enrolled in ACA plans: 12.38%

2. Georgia

• Percent of population enrolled in ACA plans: 13.51%
• Number of ACA enrollees: 1510852
• Average monthly premium paid by individual: $74
• Average monthly premium credit at stake: $546
• Average monthly cost of plan: $620
• Percent of children enrolled in ACA plans: 5.49%

3. Texas

• Percent of population enrolled in ACA plans: 12.68%
• Number of ACA enrollees: 3966226
• Average monthly premium paid by individual: $57
• Average monthly premium credit at stake: $516
• Average monthly cost of plan: $573
• Percent of children enrolled in ACA plans: 7.06%

4. Utah

• Percent of population enrolled in ACA plans: 12.04%
• Number of ACA enrollees: 421890
• Average monthly premium paid by individual: $70
• Average monthly premium credit at stake: $444
• Average monthly cost of plan: $514
• Percent of children enrolled in ACA plans: 12.57%

5. South Carolina

• Percent of population enrolled in ACA plans: 11.53%
• Number of ACA enrollees: 631948
• Average monthly premium paid by individual: $73
• Average monthly premium credit at stake: $499
• Average monthly cost of plan: $572
• Percent of children enrolled in ACA plans: 5.30%

6. Mississippi

• Percent of population enrolled in ACA plans: 11.49%
• Number of ACA enrollees: 338159
• Average monthly premium paid by individual: $41
• Average monthly premium credit at stake: $564
• Average monthly cost of plan: $605
• Percent of children enrolled in ACA plans: 2.64%

7. Alabama

• Percent of population enrolled in ACA plans: 9.26%
• Number of ACA enrollees: 477838
• Average monthly premium paid by individual: $65
• Average monthly premium credit at stake: $584
• Average monthly cost of plan: $649
• Percent of children enrolled in ACA plans: 1.52%

8. Tennessee

• Percent of population enrolled in ACA plans: 8.89%
• Number of ACA enrollees: 642867
• Average monthly premium paid by individual: $72
• Average monthly premium credit at stake: $562
• Average monthly cost of plan: $634
• Percent of children enrolled in ACA plans: 2.94%

9. North Carolina

• Percent of population enrolled in ACA plans: 8.83%
• Number of ACA enrollees: 975110
• Average monthly premium paid by individual: $97
• Average monthly premium credit at stake: $540
• Average monthly cost of plan: $637
• Percent of children enrolled in ACA plans: 3.74%

10. Wyoming

• Percent of population enrolled in ACA plans: 7.94%
• Number of ACA enrollees: 46643
• Average monthly premium paid by individual: $134
• Average monthly premium credit at stake: $872
• Average monthly cost of plan: $1,006
• Percent of children enrolled in ACA plans: 5.93%

11. Oklahoma

• Percent of population enrolled in ACA plans: 7.52%
• Number of ACA enrollees: 307989
• Average monthly premium paid by individual: $78
• Average monthly premium credit at stake: $538
• Average monthly cost of plan: $616
• Percent of children enrolled in ACA plans: 3.61%

12. Nebraska

• Percent of population enrolled in ACA plans: 6.82%
• Number of ACA enrollees: 136684
• Average monthly premium paid by individual: $114
• Average monthly premium credit at stake: $573
• Average monthly cost of plan: $687
• Percent of children enrolled in ACA plans: 5.12%

13. Montana

• Percent of population enrolled in ACA plans: 6.79%
• Number of ACA enrollees: 77221
• Average monthly premium paid by individual: $151
• Average monthly premium credit at stake: $483
• Average monthly cost of plan: $634
• Percent of children enrolled in ACA plans: 4.51%

14. Kansas

• Percent of population enrolled in ACA plans: 6.73%
• Number of ACA enrollees: 200046
• Average monthly premium paid by individual: $106
• Average monthly premium credit at stake: $543
• Average monthly cost of plan: $649
• Percent of children enrolled in ACA plans: 2.77%

15. Missouri

• Percent of population enrolled in ACA plans: 6.68%
• Number of ACA enrollees: 417000
• Average monthly premium paid by individual: $91
• Average monthly premium credit at stake: $530
• Average monthly cost of plan: $621
• Percent of children enrolled in ACA plans: 2.63%

16. Louisiana

• Percent of population enrolled in ACA plans: 6.37%
• Number of ACA enrollees: 292994
• Average monthly premium paid by individual: $72
• Average monthly premium credit at stake: $570
• Average monthly cost of plan: $642
• Percent of children enrolled in ACA plans: 2.00%

17. South Dakota

• Percent of population enrolled in ACA plans: 5.92%
• Number of ACA enrollees: 54721
• Average monthly premium paid by individual: $125
• Average monthly premium credit at stake: $566
• Average monthly cost of plan: $691
• Percent of children enrolled in ACA plans: 5.23%

18. Idaho

• Percent of population enrolled in ACA plans: 5.86%
• Number of ACA enrollees: 117373
• Average monthly premium paid by individual: $129
• Average monthly premium credit at stake: $353
• Average monthly cost of plan: $482
• Percent of children enrolled in ACA plans: 5.99%

19. Arizona

• Percent of population enrolled in ACA plans: 5.58%
• Number of ACA enrollees: 423025
• Average monthly premium paid by individual: $113
• Average monthly premium credit at stake: $411
• Average monthly cost of plan: $524
• Percent of children enrolled in ACA plans: 3.29%

20. Massachusetts

• Percent of population enrolled in ACA plans: 5.45%
• Number of ACA enrollees: 389191
• Average monthly premium paid by individual: $198
• Average monthly premium credit at stake: $337
• Average monthly cost of plan: $535
• Percent of children enrolled in ACA plans: 1.43%

21. New Jersey

• Percent of population enrolled in ACA plans: 5.40%
• Number of ACA enrollees: 513217
• Average monthly premium paid by individual: $179
• Average monthly premium credit at stake: $494
• Average monthly cost of plan: $673
• Percent of children enrolled in ACA plans: 2.10%

22. Arkansas

• Percent of population enrolled in ACA plans: 5.40%
• Number of ACA enrollees: 166639
• Average monthly premium paid by individual: $124
• Average monthly premium credit at stake: $467
• Average monthly cost of plan: $591
• Percent of children enrolled in ACA plans: 2.97%

23. North Dakota

• Percent of population enrolled in ACA plans: 5.39%
• Number of ACA enrollees: 42901
• Average monthly premium paid by individual: $145
• Average monthly premium credit at stake: $440
• Average monthly cost of plan: $585
• Percent of children enrolled in ACA plans: 5.60%

24. Wisconsin

• Percent of population enrolled in ACA plans: 5.26%
• Number of ACA enrollees: 313579
• Average monthly premium paid by individual: $167
• Average monthly premium credit at stake: $520
• Average monthly cost of plan: $687
• Percent of children enrolled in ACA plans: 1.70%

25. Michigan

• Percent of population enrolled in ACA plans: 5.24%
• Number of ACA enrollees: 531083
• Average monthly premium paid by individual: $131
• Average monthly premium credit at stake: $409
• Average monthly cost of plan: $540
• Percent of children enrolled in ACA plans: 2.80%

26. Indiana

• Percent of population enrolled in ACA plans: 5.19%
• Number of ACA enrollees: 359240
• Average monthly premium paid by individual: $120
• Average monthly premium credit at stake: $383
• Average monthly cost of plan: $503
• Percent of children enrolled in ACA plans: 2.15%

27. Vermont

• Percent of population enrolled in ACA plans: 5.07%
• Number of ACA enrollees: 32862
• Average monthly premium paid by individual: $220
• Average monthly premium credit at stake: $847
• Average monthly cost of plan: $1,067
• Percent of children enrolled in ACA plans: 1.81%

28. Delaware

• Percent of population enrolled in ACA plans: 5.03%
• Number of ACA enrollees: 52931
• Average monthly premium paid by individual: $217
• Average monthly premium credit at stake: $532
• Average monthly cost of plan: $749
• Percent of children enrolled in ACA plans: 3.13%

29. California

• Percent of population enrolled in ACA plans: 5.02%
• Number of ACA enrollees: 1979504
• Average monthly premium paid by individual: $187
• Average monthly premium credit at stake: $499
• Average monthly cost of plan: $686
• Percent of children enrolled in ACA plans: 1.85%

30. New Hampshire

• Percent of population enrolled in ACA plans: 4.99%
• Number of ACA enrollees: 70337
• Average monthly premium paid by individual: $230
• Average monthly premium credit at stake: $239
• Average monthly cost of plan: $469
• Percent of children enrolled in ACA plans: 2.47%

31. Ohio

• Percent of population enrolled in ACA plans: 4.91%
• Number of ACA enrollees: 583443
• Average monthly premium paid by individual: $126
• Average monthly premium credit at stake: $454
• Average monthly cost of plan: $580
• Percent of children enrolled in ACA plans: 2.11%

32. Colorado

• Percent of population enrolled in ACA plans: 4.74%
• Number of ACA enrollees: 282481
• Average monthly premium paid by individual: $205
• Average monthly premium credit at stake: $365
• Average monthly cost of plan: $570
• Percent of children enrolled in ACA plans: 2.90%

33. Maine

• Percent of population enrolled in ACA plans: 4.60%
• Number of ACA enrollees: 64678
• Average monthly premium paid by individual: $245
• Average monthly premium credit at stake: $513
• Average monthly cost of plan: $758
• Percent of children enrolled in ACA plans: 2.81%

34. Virginia

• Percent of population enrolled in ACA plans: 4.41%
• Number of ACA enrollees: 388856
• Average monthly premium paid by individual: $135
• Average monthly premium credit at stake: $354
• Average monthly cost of plan: $489
• Percent of children enrolled in ACA plans: 2.83%

35. Iowa

• Percent of population enrolled in ACA plans: 4.22%
• Number of ACA enrollees: 136833
• Average monthly premium paid by individual: $141
• Average monthly premium credit at stake: $414
• Average monthly cost of plan: $555
• Percent of children enrolled in ACA plans: 1.51%

36. Connecticut

• Percent of population enrolled in ACA plans: 4.11%
• Number of ACA enrollees: 151151
• Average monthly premium paid by individual: $223
• Average monthly premium credit at stake: $695
• Average monthly cost of plan: $918
• Percent of children enrolled in ACA plans: 1.37%

37. Maryland

• Percent of population enrolled in ACA plans: 3.95%
• Number of ACA enrollees: 247243
• Average monthly premium paid by individual: $184
• Average monthly premium credit at stake: $308
• Average monthly cost of plan: $492
• Percent of children enrolled in ACA plans: 1.11%

38. Alaska

• Percent of population enrolled in ACA plans: 3.88%
• Number of ACA enrollees: 28736_toggle
• Average monthly premium paid by individual: $223
• Average monthly premium credit at stake: $882
• Average monthly cost of plan: $1,105
• Percent of children enrolled in ACA plans: 2.74%

39. Washington

• Percent of population enrolled in ACA plans: 3.87%
• Number of ACA enrollees: 308227
• Average monthly premium paid by individual: $288
• Average monthly premium credit at stake: $341
• Average monthly cost of plan: $629
• Percent of children enrolled in ACA plans: 1.17%

40. Pennsylvania

• Percent of population enrolled in ACA plans: 3.80%
• Number of ACA enrollees: 496661
• Average monthly premium paid by individual: $187
• Average monthly premium credit at stake: $468
• Average monthly cost of plan: $655
• Percent of children enrolled in ACA plans: 1.37%

41. West Virginia

• Percent of population enrolled in ACA plans: 3.79%
• Number of ACA enrollees: 67113
• Average monthly premium paid by individual: $101
• Average monthly premium credit at stake: $1,069
• Average monthly cost of plan: $1,170
• Percent of children enrolled in ACA plans: 0.99%

42. Rhode Island

• Percent of population enrolled in ACA plans: 3.79%
• Number of ACA enrollees: 42117
• Average monthly premium paid by individual: $155
• Average monthly premium credit at stake: $413
• Average monthly cost of plan: $568
• Percent of children enrolled in ACA plans: 0.89%

43. Illinois

• Percent of population enrolled in ACA plans: 3.67%
• Number of ACA enrollees: 465985
• Average monthly premium paid by individual: $190
• Average monthly premium credit at stake: $484
• Average monthly cost of plan: $674
• Percent of children enrolled in ACA plans: 1.40%

44. Nevada

• Percent of population enrolled in ACA plans: 3.39%
• Number of ACA enrollees: 110687
• Average monthly premium paid by individual: $152
• Average monthly premium credit at stake: $403
• Average monthly cost of plan: $555
• Percent of children enrolled in ACA plans: 2.51%

45. New Mexico

• Percent of population enrolled in ACA plans: 3.30%
• Number of ACA enrollees: 70373
• Average monthly premium paid by individual: $152
• Average monthly premium credit at stake: $505
• Average monthly cost of plan: $657
• Percent of children enrolled in ACA plans: 1.30%

46. Oregon

• Percent of population enrolled in ACA plans: 3.27%
• Number of ACA enrollees: 139688
• Average monthly premium paid by individual: $272
• Average monthly premium credit at stake: $424
• Average monthly cost of plan: $696
• Percent of children enrolled in ACA plans: 1.49%

47. Minnesota

• Percent of population enrolled in ACA plans: 2.62%
• Number of ACA enrollees: 151512
• Average monthly premium paid by individual: $307
• Average monthly premium credit at stake: $222
• Average monthly cost of plan: $529
• Percent of children enrolled in ACA plans: 1.40%

48. Kentucky

• Percent of population enrolled in ACA plans: 2.12%
• Number of ACA enrollees: 97374
• Average monthly premium paid by individual: $180
• Average monthly premium credit at stake: $421
• Average monthly cost of plan: $601
• Percent of children enrolled in ACA plans: 0.67%

49. Hawaii

• Percent of population enrolled in ACA plans: 1.70%
• Number of ACA enrollees: 24606
• Average monthly premium paid by individual: $252
• Average monthly premium credit at stake: $477
• Average monthly cost of plan: $729
• Percent of children enrolled in ACA plans: 0.59%

50. New York

• Percent of population enrolled in ACA plans: 1.12%
• Number of ACA enrollees: 221534
• Average monthly premium paid by individual: $532
• Average monthly premium credit at stake: $259
• Average monthly cost of plan: $791
• Percent of children enrolled in ACA plans: 0.24%

Data and Methodology

Data comes from the Centers for Medicare & Medicaid Services 2025 Marketplace Open Enrollment Period Public Use Files. Per capita figures are derived using data from the U.S. Census Bureau 1-Year American Community Survey for 2024. States are ranked based on the number of enrollees in ACA healthcare plans relative to the total population. 

Questions about this study? Contact us at press@smartasset.com

Photo credit: ©iStock.com/Dragos Condrea