AHIP study: A look at health coverage across states 

Health insurance form payer plan enroll
A new report from America’s Health Insurance Plans analyzes state-by-state insurance coverage trends. (Valeriya/Getty)

Insurers paid out $20 billion in state premium taxes in 2017 and either indirectly or directly employed more than 1.5 million people, according to a new report. 

America’s Health Insurance Plans (AHIP) released its 2019 “State-to-State" report that analyzes health coverage across the country, and it found that payers nationwide provide coverage for 170 million people across the individual, large group and small group markets. AHIP’s report does not include data on people enrolled in self-insured employer plans. An estimated 60% of employer plans are at least partially self-insured. 

The report then takes those data and breaks the information down on a state-by-state basis. For example, in California—the most populous state in the nation—insurers contributed more than $2.4 billion in premium tax and employed 167,880 people. 

In Wyoming, the state with the lowest population, by contrast, insurers contributed $24.7 million in premium taxes and employed about 1,500. 

“Insurance providers have deep roots in local communities across America,” Matt Eyles, CEO of AHIP, said in a statement. “We not only provide coverage and peace of mind for millions of Americans but also provide challenging, well-paying job opportunities with benefits that support and sustain local economies.” 

RELATED: As states race to expand Medicaid, AHIP study reaffirms the program’s value 

Of the 170 million people included in the study, 54 million are enrolled in Medicaid plans and 42.3 million are enrolled in a large group plan. Close to 20 million are Medicare Advantage members, and an additional 13.4 million have Medigap supplemental coverage. 

In addition, 15.6 million people are enrolled in a high-deductible health plan or a plan with an attached health savings account. About 12.9 million seek care on the individual markets and about the same number are enrolled in small group plans. 

Here’s a look at how the data break down in the five most-populous U.S. states: 


  • Premium taxes paid: $2.4 billion 
  • Insurance company employees: 167,880 
  • Covered lives: 26.8 million 
  • Medicaid enrollees: 10.7 million (expansion) 
  • Large group plan members: 8.7 million 
  • Medicare Advantage members: 2.5 million 


  • Premium taxes paid: $2.3 billion 
  • Insurance company employees: 114,251 
  • Covered lives: 11.9 million 
  • Medicaid enrollees: 4 million (non-expansion) 
  • Large group plan members: 2.4 million 
  • Medicare Advantage members: 1.5 million 


  • Premium taxes paid: $959 million 
  • Insurance company employees: 99,252 
  • Covered lives: 11 million 
  • Medicaid enrollees: 3.1 million (non-expansion) 
  • Large group plan members: 2.1 million 
  • Medicare Advantage members: 1.9 million 

New York 

  • Premium taxes paid: $1.3 billion 
  • Insurance company employees: 98,089 
  • Covered lives: 11 million 
  • Medicaid enrollees: 4.6 million (expansion) 
  • Large group plan members: 2.4 million 
  • Medicare Advantage members: 1.4 million 


  • Premium taxes paid: $808 million 
  • Insurance company employees: 83,710 
  • Covered lives: 7.2 million 
  • Medicaid enrollees: 2.3 million (expansion) 
  • Large group plan members: 1.8 million 
  • Medicare Advantage members: 1.1 million