2026 ACA Insurer County Participation Baseline

Insurer participation is a key driver of competition, plan options, and premium pricing in the Affordable Care Act (ACA) individual marketplaces. Heading into the 2026 plan year, we compiled a complete county-level dataset mapping Qualified Health Plan (QHP) options across all 50 states and the District of Columbia.

Across all 3,143 counties, insurer competition varies widely. Counting by parent company — so affiliated brands like Blue Cross Blue Shield of Michigan and its Blue Care Network HMO count as one carrier — 701 counties enjoy robust choice with five or more competing insurers, while 164 counties remain monopoly markets with a single carrier, leaving those enrollees exposed to premium swings with no alternative. The most competitive counties field as many as 10 distinct carrier groups.

Nationwide 2026 Insurer Participation Map

Hover over any county on the map below to see the count and names of the active carriers offering individual medical plans.

Filter by Carrier: -- All Carriers -- 22 HealthAlliant Health PlansAmeriHealth CaritasAntidote HealthArkansas Blue Cross and Blue ShieldAspirusAvera HealthBaylor Scott & White HealthBaystate HealthBlue Cross & Blue Shield of Rhode IslandBlue Cross Blue Shield of ArizonaBlue Cross Blue Shield of MichiganBlue Cross Blue Shield of North DakotaBlue Cross Blue Shield of WyomingBlue Cross and Blue Shield of AlabamaBlue Cross and Blue Shield of Kansas CityBlue Cross and Blue Shield of Kansas, Inc.Blue Cross and Blue Shield of LouisianaBlue Cross and Blue Shield of MassachusettsBlue Cross and Blue Shield of MinnesotaBlue Cross and Blue Shield of NebraskaBlue Cross and Blue Shield of North CarolinaBlue Cross and Blue Shield of VermontBlue Cross of IdahoBlue Shield of CaliforniaBlueCross BlueShield of South CarolinaBlueCross BlueShield of TennesseeBoston Medical Center Health SystemCHRISTUS HealthCambia Health SolutionsCapital Blue CrossCapital District Physicians' Health PlanCareFirst, Inc.CareSourceCentene CorporationCentral Health (Travis County)Chinese Community Health PlanCommunity Health Plan of WashingtonCommunityCare (Saint Francis & Ascension St. John JV)Corewell HealthCounty of Santa ClaraCoxHealthDenver HealthElevance HealthEmblemHealthFallon HealthGeisingerGroup Health Cooperative of South Central WisconsinGuideWell Mutual Holding CorporationHarbor HealthHarris Health SystemHawaii Medical Service AssociationHealth Care Service CorporationHealth First, Inc.HealthPartnersHealthfirstHighmark HealthHorizon Healthcare ServicesImperial Health HoldingsIndependence Health GroupIndependent HealthInland Empire Health PlanIntermountain HealthJefferson HealthKaiser Foundation Health Plan, Inc.L.A. Care Health PlanLifetime Healthcare CompaniesMVP Health CareMaine Community Health OptionsMarshfield Clinic Health SystemMass General BrighamMcLaren Health CareMedicaMedical Mutual of OhioMercyhealthModa, Inc.Molina Healthcare, Inc.Montana Health CooperativeNYC Health + HospitalsNeighborhood Health Plan of Rhode IslandNetwork Health (Ascension WI & Froedtert Health JV)OctaveOscar Health, Inc.PacificSource Health PlansPoint32HealthPremera Blue CrossPresbyterian Healthcare ServicesProMedicaProvidenceQuartz Health SolutionsRenown HealthSSM HealthSanford HealthSantaFe HealthCare, Inc.Sentara HealthSharp HealthCareSt. Luke's Health SystemSumma HealthTaro HealthThe Cigna GroupUCareUPMCUnitedHealth GroupUniversity Health (San Antonio)University of Utah HealthWellmark, Inc.Western Health Advantage

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