Coverage by state
Where the decisions are published
External review is a state-by-state patchwork, and the map is worse than it looks. One state publishes decisions in a form anyone can analyse. Three of the ten largest insurance markets run no state process at all.
11 of 51 states were surveyed. The remaining 40 are marked not surveyed, which means nobody checked — not “probably nothing”. Filling those pages with plausible text about processes we never looked at would be inventing facts, and it would be invisible, because the text would all be roughly true. They stay blank until someone does the work.
Publishes decisions
1 statePer-decision outcomes with the reviewer's reasoning, and a route to collect them.
Publishes, but unreachable
1 stateDecision-level reasoning exists and there is no permitted route to collect it.
Aggregate counts only
6 statesAnnual totals. Useful context; not a dataset — no class, no reasoning, no decisions.
No state process, or nothing published
3 statesExternal appeals go to the federal process, which publishes neither decisions nor outcome statistics.
Not surveyed
40 statesWe have not checked this state. That is not a finding, and we will not guess.
- ALAlabama
- AKAlaska
- AZArizona
- ARArkansas
- COColorado
- CTConnecticut
- DEDelaware
- DCDistrict of Columbia
- HIHawaii
- IDIdaho
- INIndiana
- IAIowa
- KSKansas
- KYKentucky
- LALouisiana
- MEMaine
- MDMaryland
- MAMassachusetts
- MNMinnesota
- MSMississippi
- MOMissouri
- MTMontana
- NENebraska
- NVNevada
- NHNew Hampshire
- NMNew Mexico
- NDNorth Dakota
- OKOklahoma
- OROregon
- RIRhode Island
- SCSouth Carolina
- SDSouth Dakota
- TNTennessee
- UTUtah
- VTVermont
- VAVirginia
- WAWashington
- WVWest Virginia
- WIWisconsin
- WYWyoming
The state map is only half of the coverage question. A self-funded employer plan goes to the federal process no matter which state you live in, and roughly half of Americans with employer coverage are in one. Whether this covers you covers both gaps together.