1.0KFFhttps://www.kff.orgkffmeghanshttps://www.kff.org/author/kffmeghans/Claims Denials and Appeals in ACA Marketplace Plans in 2023 | KFFrich600338<blockquote class="wp-embedded-content" data-secret="fYESTPhviQ"><a href="https://www.kff.org/private-insurance/claims-denials-and-appeals-in-aca-marketplace-plans-in-2023/">Claims Denials and Appeals in ACA Marketplace Plans in 2023</a></blockquote><iframe sandbox="allow-scripts" security="restricted" src="https://www.kff.org/private-insurance/claims-denials-and-appeals-in-aca-marketplace-plans-in-2023/embed/#?secret=fYESTPhviQ" width="600" height="338" title="“Claims Denials and Appeals in ACA Marketplace Plans in 2023” — KFF" data-secret="fYESTPhviQ" frameborder="0" marginwidth="0" marginheight="0" scrolling="no" class="wp-embedded-content"></iframe><script type="text/javascript">
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https://www.kff.org/wp-content/uploads/sites/7/2025/01/250124_Claims-Denied-by-healthcare.gov-in-2023_FI_2.png38402160This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for denials is limited, and few consumers appeal claims denials.