Dataset · published 2026-08-14 · Daniel Griffin, NPN #22052447 · free to reuse with attribution (CC BY 4.0)
Eleven states sell no PPO anywhere on the marketplace
Across 30 states in the CMS Plan Year 2026 landscape file, eleven have zero PPO plans in any county: Arizona, Indiana, Kansas, Missouri, Mississippi, New Hampshire, Ohio, Oregon, Tennessee, Texas and Utah. In those states every marketplace plan is an HMO, EPO or POS — closed networks with referrals, and effectively no out-of-area coverage beyond emergencies.
Download the data
30 rows. Free to use, cite “Coverage by County (Health Advisory, NPN #22052447)”.
Download CSV →JSON · CC BY 4.0 · updated 2026-08-14
What is in it
Texas is the largest: no PPO in any of its 254 rating counties. Iowa has one in 7% of counties, Wisconsin 21%, Nebraska 37%. This matters most for people whose work crosses state lines — long-haul drivers, travelling trades, anyone with a specialist out of area.
Sample of the data
| state | counties | counties with ppo | ppo pct | plan types | median silver40 month | median family4 month | median family4 year |
|---|---|---|---|---|---|---|---|
| AZ | 15 | 0 | 0.0 | HMO | 705.55 | 2255.78 | 27069.36 |
| IN | 92 | 0 | 0.0 | EPO,HMO,POS | 466.92 | 1492.82 | 17913.84 |
| KS | 105 | 0 | 0.0 | EPO | 698.0 | 2231.64 | 26779.68 |
| MO | 115 | 0 | 0.0 | EPO | 715.04 | 2286.1 | 27433.2 |
| MS | 82 | 0 | 0.0 | EPO,HMO | 683.97 | 2047.64 | 24571.68 |
| NH | 10 | 0 | 0.0 | EPO,HMO | 401.31 | 1283.04 | 15396.48 |
| OH | 88 | 0 | 0.0 | HMO | 525.61 | 1680.48 | 20165.76 |
| OR | 36 | 0 | 0.0 | EPO | 591.0 | 1770.0 | 21240.0 |
| TN | 95 | 0 | 0.0 | EPO | 700.74 | 2240.4 | 26884.8 |
| TX | 254 | 0 | 0.0 | EPO,HMO,POS | 710.99 | 2273.17 | 27278.04 |
| UT | 29 | 0 | 0.0 | EPO,HMO | 798.02 | 2451.78 | 29421.36 |
| IA | 99 | 7 | 7.1 | EPO,HMO,PPO | 518.28 | 1657.04 | 19884.48 |
| WI | 72 | 15 | 20.8 | EPO,HMO,POS,PPO | 623.29 | 1992.78 | 23913.36 |
| NE | 93 | 34 | 36.6 | EPO,PPO | 777.64 | 2486.26 | 29835.12 |
| NC | 100 | 90 | 90.0 | EPO,HMO,POS,PPO | 685.6 | 2191.98 | 26303.76 |
Method and sources
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. Poverty guidelines are HHS 2025, which govern 2026 coverage. Premiums are filed rates before any premium tax credit and are not a quote or an offer of coverage. Compiled by Daniel Griffin, licensed independent insurance agent (NPN #22052447). Reuse freely under CC BY 4.0 with attribution to Coverage by County.