Based on guidelines used by the Department of Justice and Federal Trade Commission to assess market competition, 75% of U.S. commercial health insurance markets were highly concentrated in 2018, up from 71% in 2014, according to a study released today by the American Medical Association. Fifty-eight percent of markets experienced an increase in concentration over the four-year period. In 91% of the 382 metropolitan statistical areas studied, at least one insurer had a commercial market share of 30% or more in 2018; and in 48% of MSAs, one insurer’s share was at least 50%. “Our findings should prompt federal and state antitrust authorities to vigorously examine the competitive effects of proposed mergers between health insurers,” the report concludes. The findings are based on enrollment data for health maintenance organizations, preferred provider organizations and point-of-service plans, consumer-driven health plans and public health exchanges.

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