Alabama has the highest average in-network denial rate for ACA insurers, while South Dakota has the lowest, according to KFF.
KFF analyzed CMS data on claims denials and appeals for non-group qualified health plans offered on the federal exchange in 2023. Denial rates at the individual insurer-level had high variability in some states. Insurers ranked by ACA claim denial rates are here.
States ranked by average ACA claim denial rates:
Alabama: 34%
Oklahoma: 29%
Alaska: 25%
Hawaii: 24%
Indiana: 23%
Texas: 22%
Arizona: 21%
Illinois: 20%
Ohio: 19%
Nebraska: 19%
Tennessee: 19%
Iowa: 19%
Utah: 19%
South Carolina: 18%
North Carolina: 18%
New Hampshire: 18%
Missouri: 17%
Louisiana: 17%
Florida: 16%
Wisconsin: 16%
West Virginia: 16%
Wyoming: 15%
Mississippi: 15%
Kansas: 15%
Michigan: 15%
Delaware: 14%
Arkansas: 14%
Montana: 13%
North Dakota: 12%
Oregon: 9%
South Dakota: 6%