COBRA vs Marketplace Calculator: All 50 States + DC (2026)

How State-Level Health Insurance Costs Vary

COBRA premiums are simply 102% of whatever your employer's plan cost — so they track each state's underlying health care cost structure closely. ACA Marketplace premiums also vary by state because each state has its own insurers, provider networks, and benchmark "second-lowest-cost Silver plan" used to calculate Premium Tax Credits. States that run their own exchange (like Covered California, Pennie in Pennsylvania, or NY State of Health) sometimes add state-funded subsidies on top of federal ones, which this calculator does not model — check your state Marketplace directly for the latest add-on programs.

Medicaid expansion status also matters: in the 10 states that have not adopted full ACA Medicaid expansion (Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming), very low-income adults can fall into a coverage gap. Click any state above for a calculator pre-loaded with that state's numbers, plus state-specific FAQs.