State Exclusions Are Quietly Limiting New Patient Starts

February 11, 2026Jeremy Mittler

Many healthcare campaigns are quietly limiting new patient starts. Not because ROI is poor. And not because patients don't exist in certain states. But because of how audiences are built.

The State Exclusion Problem

To reduce privacy risk, many companies and ad platforms exclude residents of states like Washington, Nevada, Connecticut, and Colorado.

It makes a lot of sense as a way to reduce risk.

But it also cuts campaigns off from qualified patients.

The Real Issue Isn't Privacy Laws

It's modeled audiences.

Modeled methods rely on predictions and inferences about individuals. Under state privacy laws, that creates real risk. So companies respond the only way they can.

Entire states disappear from the media plan.

Not to improve performance. But because the method isn't good enough.

That is a performance problem.

Why This Caps Growth

New patient starts don't happen evenly across the country. And excluding patients based on where they live is one of the fastest ways to cap growth.

Yes, privacy rules have evolved. But so have the audience methods that can comply with them.

What Works Instead

Health audiences built on evidence at the group level.

No inference. No modeling. No need to exclude states to feel safe.

If running your campaigns requires removing entire states, the issue is the audience method.

Run Campaigns Across All 50 States

At Blueprint Audiences, we build evidence-based audiences that comply nationally—no state exclusions required. If you want to test an audience that can run across all 50 states while improving performance, we're happy to walk through what that looks like.

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About the Author: Jeremy Mittler is the founder of Blueprint Audiences, a privacy-first healthcare audience company that helps pharmaceutical and healthcare marketers reach patients without compromising on compliance or performance.