How we built “The Benchmark-Premium Gap Across HealthCare.gov States, 2026” — the metric, the sources, the limitations, and how to reproduce every number.
The metric
Age-40 benchmark (second-lowest-cost Silver) premiums across the 30 HealthCare.gov states, 2026: Wyoming averages $1,099/month - 2.65x New Hampshire's $414, an $8,222-a-year gap for the same benchmark tier.
Breakdown dimension: state (HealthCare.gov / FFM states only), plan years 2025-2026. Data vintage: CMS QHP Landscape Individual Market Medical, PY2025 + PY2026 (data.healthcare.gov, official primary); same as states.
Sources
- CMS QHP Landscape Individual Market Medical, PY2025 + PY2026 (data.healthcare.gov, official primary)
- same as states
Canopy Press analysis of CMS QHP Landscape files (plan years 2025-2026), data.healthcare.gov. HealthCare.gov states only.
How it’s computed
All figures are deterministic arithmetic on the official series above — no estimates, no modeling. Raw API responses are snapshotted at the stated vintage; every published figure must reproduce from those snapshots before publication (an automated audit gate recomputes the table, the chart values, and the CSV byte-for-byte, and blocks publication on any mismatch).
Limitations
- SCOPE: HealthCare.gov (FFM) states ONLY - the CMS QHP Landscape files contain no State-Based Marketplace states, so California, New York, Pennsylvania, Maryland, Vermont and 16 other SBM jurisdictions are absent by construction. This is never a 50-state comparison, and no clean national SLCSP comparison exists in any single primary file.
- State values are UNWEIGHTED means of county-level SLCSP - CMS's own published headline uses plan-selection weighting, which is why CMS reports roughly a 30% average benchmark increase for 2026 where this method shows ~26%. Within-state rating-area variation is substantial.
- Premiums are the age-40 single nonsmoker EHB portion of the gross premium. Most enrollees receive premium tax credits and pay far less than these gross amounts; the gap shown is what the MARKET prices, not what a subsidized enrollee pays.
- Age-rating multiplies these levels (a 60-year-old pays roughly 2x an age-40 in most states); tobacco surcharges and family composition are excluded.
- Year-over-year comparisons reflect both price changes and plan-availability shifts (the second-lowest plan can be a different plan each year - that is the nature of the benchmark).
Reproduce it
Pull the series listed above from the official APIs at the stated vintage and recompute. Verification values (recomputed before publish):
| Check | Value |
|---|---|
| wy_slcsp_2026 | 1099.36 |
| nh_slcsp_2026 | 414.17 |
| gap_ratio | 2.65 |
| annual_gap_usd | 8222.0 |
| wv_slcsp_2026 | 1072.36 |
| ak_slcsp_2026 | 1035.83 |
| tx_slcsp_2026 | 745.95 |
| fl_yoy_pct | 31.8 |
| wy_slcsp_2025 | 878.35 |
| ffm_yoy_mean_pct | 25.9 |
Accountability
Canopy Press research is produced by a methodology-driven, human-overseen pipeline. John Fox, Founder & Head of Research, is responsible for the data methodology and editorial standards behind this asset. Corrections: [email protected]. See our Editorial Standards and the research changelog.