Marketplace insurers deny 1 in 5 claims, Americans pay hundreds monthly

New data shows insurers on the federal and state marketplaces deny nearly 20% of claims, forcing patients to pay hundreds monthly out-of-pocket. This denial rate is significantly higher than group commercial plans. For practices that see a large number of ACA marketplace patients, this translates to increased administrative burden and slower cash flow. Monitor your 2026 denial reports for marketplace plans; if the 20% rate holds in your data, consider tightening point-of-service collection policies and accelerating patient responsibility estimates before service.