Open data · CMS
Marketplace claim-denial rates by state
Download state-level aggregate marketplace claim-denial rates from CMS Transparency in Coverage filings. The extract keeps only states with enough reported claims for a meaningful state-level denominator.
31
states in the extract
471.0M
reported claims represented
Download the data
Both formats are generated from the same state-level aggregate rows used in PlainInsurer's health-insurance comparisons. The 50,000-claim threshold prevents a sparse filing from implying a precise state rate.
Fields: state, state name, claims received, claims denied, denial rate, and number of reporting issuers.
Scope and source
This is marketplace data only. It does not represent employer plans, Medicare, every insurance product, or states whose exchange data are not included in the federal filing set.
A denial rate is a filed claim-status measure, not a verdict on a carrier or a prediction of an individual outcome. Read the denial-rate guide and methodology before comparing plans.