Most states continue to have two insurers that hold at least 50% combined market share.
| State | Top insurer | Market share | Second insurer | Market share |
|---|---|---|---|---|
| Alabama | BCBS AL | 86% | UnitedHealth Group | 5% |
| Alaska | Premera | 46% | Aetna | 46% |
| Arizona | UnitedHealth Group | 30% | Aetna | 23% |
| Arkansas | BCBS AR | 47% | UnitedHealth Group | 20% |
| California | Kaiser | 37% | Elevance Health | 23% |
| Colorado | UnitedHealth Group | 24% | Elevance Health | 24% |
| Connecticut | Elevance Health | 39% | UnitedHealth Group | 19% |
| Delaware | Highmark | 57% | CVS (Aetna) | 26% |
| District of Columbia | CareFirst | 33% | UnitedHealth Group | 16% |
| Florida | BCBS FL | 38% | UnitedHealth Group | 19% |
| Georgia | Elevance Health | 36% | Cigna | 15% |
| Hawaii | HMSA (BCBS HI) | 63% | Kaiser | 20% |
| Idaho | BC of ID | 45% | Cambia | 13% |
| Illinois | HCSC (BCBS) | 61% | UnitedHealth Group | 14% |
| Indiana | Elevance Health | 56% | UnitedHealth Group | 15% |
| Iowa | Wellmark (BCBS) | 49% | UnitedHealth Group | 28% |
| Kansas | BCBS KS | 45% | UnitedHealth Group | 14% |
| Kentucky | Elevance Health | 66% | Humana | 12% |
| Louisiana | BCBS LA | 66% | UnitedHealth Group | 16% |
| Maine | Elevance Health | 50% | Point32Health | 14% |
| Maryland | CareFirst | 46% | Cigna | 15% |
| Massachusetts | BCBS MA | 36% | Point32Health | 33% |
| Michigan | BCBS MI | 67% | Corewell (Priority) | 12% |
| Minnesota | BCBS MN | 46% | HealthPartners | 17% |
| Mississippi | BCBS MS | 54% | UnitedHealth Group | 17% |
| Missouri | Elevance Health | 27% | UnitedHealth Group | 24% |
| Montana | HCSC (BCBS) | 41% | Cigna | 29% |
| Nebraska | BCBS NE | 45% | UnitedHealth Group | 26% |
| Nevada | UnitedHealth Group | 35% | Elevance Health | 24% |
| New Hampshire | Elevance Health | 46% | Cigna | 19% |
| New Jersey | Horizon BCBS | 41% | Aetna | 25% |
| New Mexico | HCSC (BCBS) | 48% | Presbyterian | 21% |
| New York | UnitedHealth Group | 27% | Elevance Health | 17% |
| North Carolina | BCBS NC | 51% | UnitedHealth Group | 18% |
| North Dakota | BCBS ND | 47% | Sanford | 34% |
| Ohio | Elevance Health | 36% | Medical Mutual | 20% |
| Oklahoma | HCSC (BCBS) | 56% | UnitedHealth Group | 15% |
| Oregon | Cambia | 21% | Cigna | 20% |
| Pennsylvania | Highmark | 27% | Aetna | 17% |
| Rhode Island | BCBS RI | 42% | UnitedHealth Group | 28% |
| South Carolina | BCBS SC | 63% | UnitedHealth Group | 13% |
| South Dakota | Avera Hlth | 35% | Wellmark (BCBS) | 30% |
| Tennessee | BCBS TN | 41% | Cigna | 27% |
| Texas | HCSC (BCBS) | 39% | UnitedHealth Group | 20% |
| Utah | Intermountain | 44% | Cambia | 14% |
| Vermont | BCBS VT | 55% | Cigna | 24% |
| Virginia | Elevance Health | 44% | Aetna | 13% |
| Washington | Kaiser | 23% | Premera | 22% |
| West Virginia | Highmark | 55% | Cigna | 13% |
| Wisconsin | UnitedHealth Group | 26% | Elevance Health | 21% |
| Wyoming | Cigna | 41% | BCBS WY | 32% |
Percentages are derived from combined PPO, HMO, POS and exchange markets