Key numbers (as of August 2026): – 23,130,860 people selected a 2026 Marketplace plan nationwide (KFF, 2026 open enrollment). – Texas fields the most carriers at 15, and the national average is nine per state (KFF, 2026). – 165 counties had just one carrier on the 2026 Marketplace, up from 93 the year before (KFF, June 2026). – A fresh exclusive ACA lead runs about $30 to $80 (Aged Lead Store, 2026).
Quick answers: Which states have the most carriers? | Are cheap leads in small states worth it? | What do health insurance leads cost? | Does this cover who qualifies?
The one number that decides whether a lead closes
Most “best states” lists for insurance rank on population or internet penetration. That tells you where people live, not where you can close them. A health insurance lead is only worth buying if the agent can put a plan the prospect will actually sign up for in front of them, and that takes carriers competing for the business.
So rank the states on carrier count first. It is the cleanest public signal of how many plan options an agent can offer, and it moves a lot. Texas fields 15 carriers on its 2026 Marketplace, while KFF’s state table puts Florida, California and Wisconsin at 11 and New York at 12. The national average is nine carriers per state in 2026, and KFF reports that is the first decline since 2018. A prospect in a 15-carrier state has real choice. A prospect in a two-carrier state has an offer and a shrug.
The second axis is market depth: how many people actually buy coverage there. Depth decides supply, and supply decides price. A deep market has vendors competing to sell you leads, so a fresh exclusive lead is available and the price is disciplined. A shallow market has thin inventory, so you either pay up for volume that is not there or you pad the order with aged records.
One distinction to keep straight before you route a dollar: a U65 lead is not an ACA lead. The figures below are on-exchange ACA Marketplace signals, and they proxy the whole picture well because the same carriers largely write the off-exchange U65 book too. But the products, the seasons and the buyers differ, so read whether you are buying a U65 lead or an ACA lead before you set targeting.
The states worth your fresh-lead budget
The deep, competitive states are where the same lead dollar reaches a closeable prospect. The table ranks the field on the two axes that matter to a buyer, with every cell sourced to KFF. Plan-selection counts are 2026 open enrollment; carrier counts are the 2026 Marketplace.
| State | 2026 Marketplace plan selections | 2026 carriers | What it means for a lead buyer |
|---|---|---|---|
| Florida | 4,538,772 | 11 | Deepest market in the country, real carrier choice. Buy fresh exclusive. |
| Texas | 4,172,233 | 15 | The most carriers anywhere and a huge market. The top routing target. |
| California | 1,927,371 | 11 | Deep, competitive, state-run exchange. Strong fresh-lead market. |
| Georgia | 1,324,295 | 8 | Big volume, competition just below average. Buy fresh, watch price. |
| North Carolina | 761,457 | 6 | Solid depth, thinner carrier bench. Fresh works, expect fewer plan matches. |
| Utah | 387,336 | 5 | Mid-depth, below-average competition. Test before you scale spend. |
| United States | 23,130,860 | 9 (avg) | The national line to measure any state against. |
| Delaware | 44,663 | 3 | Small market, three carriers. Aged or skip. |
| Rhode Island | 43,446 | 2 | Two carriers, shallow supply. No fresh-exclusive premium here. |
| Wyoming | 41,545 | 2 | Thin on both axes. Hard to place, hard to source at volume. |
| Vermont | 30,344 | 2 | Two carriers, tiny market. Aged-only at best. |
| Alaska | 26,079 | 2 | Two carriers, very thin supply. Skip for fresh spend. |
| Hawaii | 23,380 | 2 | Two carriers, smallest deep-buy case on the board. |
Sources: KFF Marketplace plan selections, 2026 and KFF number of Marketplace insurers, 2026.
Carrier counts are 2026 ACA Marketplace issuers, per KFF.
The pattern is blunt. The four largest markets carry enough competition that an agent has something to sell, and enough depth that a lead desk can fill your order without leaning on stale records. That is where fresh, exclusive spend earns its premium.
Where the same lead costs more and closes less
The bottom of the table is the half no page-one result will tell you about. In a two-carrier state, the agent has two plans to quote, so a good share of prospects walk because neither fits. The lead was closeable in Texas and is a coin-flip in Wyoming, for reasons that have nothing to do with the lead itself.
Thin supply is the price half of the problem. When a state posts 26,000 plan selections instead of four million, the lead inventory is shallow, and a fresh exclusive order either goes unfilled or gets padded with aged data. Depth is getting scarcer, too: KFF found that 165 counties had just one carrier on the 2026 Marketplace, up from 93 the year before. A single-carrier county is a place where a health lead has almost nowhere to land.
Here is the market you are buying into, by lead type. These are published industry ranges, not our rate card, and every one is whole-dollar market data.
| Lead type | Market range (per lead) | Source |
|---|---|---|
| Fresh shared, ACA | $10 to $30 | Aged Lead Store, 2026 |
| Fresh exclusive, ACA | $30 to $80 | Aged Lead Store, 2026 |
| Fresh exclusive, U65 | $25 to $60 | Aged Lead Store, 2026 |
| Live transfer | about $30 to $75 | Aged Lead Store, 2026 |
| Aged internet | well under a dollar to a few dollars | Aged Lead Store, 2026 |
One market shift is worth a line, because it moves supply. The enhanced premium tax credits expired at the end of last year, and Healthcare Dive reports that on-exchange enrollment has fallen by more than a million people, with projections of a far larger drop through 2026. The shopping pool itself is widening, though: the Census Bureau found the uninsured rate rose in 18 states and the District of Columbia between 2023 and 2024, so more people need a plan even as fewer buy one on the exchange. Higher premiums push those shoppers toward cheaper and off-exchange coverage, which is exactly the U65 pool. Where carriers still compete, that pool is growing. Where they do not, it is thinning with everything else.
What this guide does not decide
This is a supply-and-price cut, and it deliberately stops there. It does not tell you who legally qualifies for a plan or when they can enroll, because that turns on state Medicaid policy and the enrollment calendar, not on carrier count. That question flips the value of the exact same lead from state to state, and we handle it in full on who qualifies and when they can enroll. Read it alongside this one before you finalize routing.
For the pricing question in depth, what health insurance leads cost breaks the ranges down by intent and product. If you buy in more than one vertical, the same supply-and-price logic runs the state cut for solar leads. And when you want verified U65 calls and leads routed to the states where they close, that is what we do.
Frequently Asked Questions
Which states have the most health insurance carriers in 2026?
Texas has the most, with 15 carriers on its 2026 ACA Marketplace, according to KFF. New York follows at 12, and Florida, California and Wisconsin each field 11. The national average is nine carriers per state, its first decline since 2018. Carrier count matters to a lead buyer because it sets how many plans an agent can quote, which is what turns a lead into a policy.
Are cheap health insurance leads in small states a good deal?
Usually not. A state like Wyoming, Alaska, Vermont, Hawaii or Rhode Island runs on just two carriers, per KFF’s 2026 table, so the agent has few plans to offer and a good share of prospects cannot be placed. The lead is cheap because it is hard to close and the supply is shallow. In those markets, buy aged at a few dollars and work it as volume, or route the budget to a deeper state.
What do health insurance leads cost?
Published market ranges run about $10 to $30 for a fresh shared ACA lead and $30 to $80 for a fresh exclusive one, per Aged Lead Store. The same source puts fresh exclusive U65 leads at about $25 to $60 and live transfers at about $30 to $75, with aged internet leads falling from a few dollars to well under a dollar as they age. Those are industry ranges, not any one seller’s rate card. The full breakdown by intent and product is in what health insurance leads cost.
Does this ranking cover who qualifies for a plan?
No, and that is on purpose. This guide ranks states on carrier competition and market depth, the supply-and-price side of the buy. Whether a given caller qualifies for a Marketplace plan or lands in Medicaid instead turns on state expansion policy and the income line, which changes state by state. We cover that dimension in full on who qualifies and when they can enroll. Read both before you set state targeting.
Cite this data (as of August 2026): Carrier counts and plan selections are from KFF State Health Facts, 2026 Marketplace (insurer participation, plan selections). Lead price ranges are published market figures from Aged Lead Store, 2026.
Buy where the carriers compete
The best states to buy health insurance leads are not a secret and not a scorecard trick. They are the deep, competitive markets where an agent has plans to sell and a lead desk has inventory to fill. If you want verified U65 calls and leads routed to those states, talk to us about your market mix or book a free consultation.
