Seventy-three percent of U.S. commercial health insurance markets are highly concentrated based on guidelines used by the Department of Justice and Federal Trade Commission to assess market competition, according to the latest annual report on health insurance competition by the American Medical Association. In 91% of the 384 metropolitan statistical areas studied, at least one insurer had a commercial market share of 30% or more, and in 46% of MSAs a single insurer’s share was at least 50%. Fifty-four percent of markets that were highly concentrated in 2014 became even more concentrated by 2020, the study found.

“These markets are ripe for the exercise of health insurer market power, which harms consumers and providers of care,” the report concludes. “Our findings should prompt federal and state antitrust authorities to vigorously examine the competitive effects of proposed mergers involving health insurers.”

The findings are based on data on commercial enrollment in preferred provider organization, health maintenance organization, point-of-service, exchange and consumer-driven health plans.

 

Related News Articles

Headline
The average annual premium for employer-sponsored family health coverage rose 4% this year to $22,221, including employer and worker contributions, according…
Headline
Open enrollment for 2022 coverage through the Health Insurance Marketplaces kicked off today. The federally facilitated marketplace is open through…
Headline
The number of uninsured U.S. residents did not change substantially during the first 12 months of the COVID-19 pandemic, according to a report released…
Headline
Starting today, consumers can preview 2022 health plans and prices at the federally facilitated Health Insurance Marketplace. Open enrollment for 2022…
Blog
The COVID-19 pandemic has exposed commercial health insurance plan practices that are impacting patient access and choices for care and driving excessive…
Perspective
Hospitals and health systems put the health and welfare of their patients first. For some of the nation’s largest commercial health insurers, unfortunately,…