States ranked by market share of largest insurer

Becker's Healthcare December 31, 2025
Jakob Emerson

Delaware’s largest payer controls 93% of the state’s health insurance market, while Washington state’s largest insurer controls just 24%, according to KFF.

The 2023 data was obtained from the “Health Coverage Portal TM,” a database maintained by Mark Farrah Associates.

States ranked by market share of largest insurer:

1. Delaware: 93%
2. Iowa: 90%
3. Utah: 87%
4. District of Columbia: 81%
5. Alabama: 79%
6. Alaska: 79%
7. Louisiana: 73%
8. Mississippi: 70%
9. Oklahoma: 68%
10. Hawaii: 67%
11. Maryland: 67%
12. Nebraska: 67%
13. New Hampshire: 67%
14. Connecticut: 66%
15. Illinois: 65%
...

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