About Denial Facts
We publish what federal data actually says about health insurance claim denials, and the appeal rights that 5,881 of 84,502,749 denials ever reached.
Axion Labs is a family-run independent publishing studio, no affiliation with any insurer, provider, or agency we write about. Contact: hello@getaxionlabs.com.
The reason this site exists is one pair of numbers: insurers denied 84,502,749 in-network claims in a single year, and 5,881 of those denials were taken to independent external review. That is one in 14,369. Of the people who went, 32.8% won.
That gap is not a legal problem. It is an information problem. Every one of those 84,502,749 people had the right to a free review by an organization their insurer does not control, whose decision the insurer must obey. The federal file records 5,881 who did.
Where the data comes from
CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. It covers individual-market Qualified Health Plans on the federal Exchange, 185 insurer-state records, 145 companies across 30 states. Employer and self-funded plans are not in this file; the appeal rights described here still apply to non-grandfathered plans.
Which release, and what came after it. The figures on this site are the plan-year 2026 release, issued September 26, 2025, covering plan-year 2024 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2026. One CMS file does carry a later issue date: the plan-year 2025 release was issued September 30, 2025, four days after this one. That is the PRIOR plan year, not a newer release, we publish by plan year, and both files are listed at data.healthcare.gov. A test in this site’s build fetches that list every time it runs and fails if CMS publishes a later plan year, or if this paragraph ever claims recency by issue date while a later-issued file exists.
What changed between the releases. Across the three Transparency in Coverage releases CMS has published, external reviews filed rose from 2,336 to 5,881 while the share overturned fell from 44% in the plan-year 2024 release to 32.8% in the plan-year 2026 release. We publish all three so the direction is visible: plan-year 2024 (issued April 14, 2025, 2022 claims), 57,590,788 denials, 2,336 external reviews, 44% overturned, 209 insurer-state records across 32 states; plan-year 2025 (issued September 30, 2025, 2023 claims), 85,894,625 denials, 5,000 external reviews, 31.5% overturned, 206 insurer-state records across 31 states; plan-year 2026 (issued September 26, 2025, 2024 claims), 84,502,749 denials, 5,881 external reviews, 32.8% overturned, 185 insurer-state records across 30 states. Source for all three: data.healthcare.gov.
What we do when CMS stops reporting a state or an insurer. The plan-year 2026 file covers 30 states and 185 insurer-state records; the plan-year 2024 file covered 32 and 209. Georgia and Illinois left the file, along with 51 insurer-state records, because they moved off the federal Exchange platform rather than because denials stopped. The two STATE pages stay up with the last figures CMS did report, name that release in their lede and in their source footer, and are left out of every total and every ranking on this site rather than being deleted or padded with dashes. The retired INSURER-STATE URLs are different: each one redirects permanently to the state page for the market it was in, which carries current figures, because a page about one company in one state has nothing current left to say once its rows leave the file. Nothing is deleted in either case, and nothing carried forward is counted in a total.
Independence
We are not affiliated with, endorsed by, or acting for any insurer, government agency, or independent review organization. We are not a law firm, a medical provider, or an insurance producer. We take no commission from any insurer.
Who runs this
Who we are. Axion Labs is a small, family-run independent publishing studio. We publish plain-English answers built from public records: GOV.UK and HMRC guidance on Making Tax Digital, the CFPB consumer complaint database, US federal health-insurance claim data, New York City parking-ticket records, and UK parking operator and appeal-body decisions. Every figure names its source and the date we read it. We are not lawyers, not an agency, and not affiliated with any company, insurer, council or government body we write about. We take no commission, no referral fee and no advertising, and we rank no product. Andrew at Axion Labs writes the pages and answers the mail: hello@getaxionlabs.com.
Denial Facts is run by Andrew at Axion Labs. One person reads the mail and answers it: hello@getaxionlabs.com.
What we sell
The reference material is free and stays free, the data, the denial-reason pages, the deadline calculator. The $29 Appeal Kit is the part the free pages cannot be: your dates. It works out your internal deadline, your plan's own answer deadline, the day deemed exhaustion triggers if they miss it, and the day your external-review window closes, in order, around your denial. One payment. No subscription. No cut of your claim. 14-day refund, no questions asked.
Corrections
hello@getaxionlabs.com, we fix errors quickly.
The federal timeframes: 180 days from the date on the denial notice to file the internal appeal, then 4 months from the final internal denial to request independent external review. Put your date in and get the actual calendar dates, with the days remaining.
Runs entirely in your browser, the date you type is never sent to us and never stored. Open the full calculator →
Counts: CMS Transparency in Coverage Public Use File (PY2026 release, PY2024 claims), data.healthcare.gov — US Government public domain. Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov. Expedited review is decided in about 72 hours under both sections.
Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136).