Interactive tool · CMS data

Claim denial rate explorer

Search any state to see its marketplace claim-denial rate and how it compares to the national average — measured from CMS Transparency-in-Coverage filings.

36%
highest (Alabama)
21%
national average
7%
lowest (South Dakota)

According to the U.S. Centers for Medicare & Medicaid Services Transparency in Coverage Public Use File (PY2025, published March 2026), PlainInsurer compares marketplace claim-denial rates across more than 1,000,000 submitted claims in the 31 states with federal marketplace filings. See our methodology for the full computation.

Every reporting state, at a glance

Marketplace claim-denial rate by state. Search above to compare any one against the national average.

% of marketplace claims denied, by state — CMS Transparency in Coverage (PY2025)
Scale: 7–13 13–19 19–24 24–30 30–36

All 31 reporting states ranked by claim-denial rate

# Insurer Claim denial rate ClaimsIssuers
1 Alabama 35.5% 15.30M3
2 Alaska 27.0% 0.78M1
3 Arizona 24.5% 10.07M7
4 Indiana 24.2% 4.65M3
5 Oklahoma 23.8% 11.02M6
6 Hawaii 23.8% 0.69M2
7 Ohio 22.1% 13.65M11
8 Tennessee 22.0% 17.59M5
9 Florida 21.9% 114.09M13
10 Texas 21.9% 111.89M15
11 Illinois 20.5% 15.99M10
12 Iowa 20.3% 5.40M3
13 Utah 19.8% 9.05M5
14 South Carolina 19.8% 17.32M4
15 North Carolina 19.7% 35.57M9
16 New Hampshire 19.1% 2.82M3
17 West Virginia 18.4% 1.30M2
18 Louisiana 17.0% 6.11M4
19 Nebraska 16.9% 3.66M4
20 Mississippi 16.6% 10.27M5
21 Kansas 16.6% 5.84M6
22 Michigan 16.5% 11.14M9
23 Wyoming 16.3% 1.56M2
24 Delaware 15.5% 1.17M3
25 Missouri 15.1% 10.96M9
26 Montana 14.7% 1.18M3
27 Wisconsin 14.3% 9.44M13
28 Arkansas 14.1% 17.62M5
29 North Dakota 13.5% 1.11M3
30 Oregon 11.4% 2.44M6
31 South Dakota 7.4% 1.39M3

Denial rates are the share of submitted marketplace claims denied in each state, from the CMS Transparency in Coverage Public Use File (PY2025). States that run their own health-insurance marketplace are not in the federal file. Methodology →