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 AHA and other hospital and health care organizations Friday urged the full U.S. Court of Appeals for the 9th Circuit to rehear Wit v. United…
Headline
An estimated 9.2% of U.S. residents, or 30 million people, lacked health insurance when surveyed in 2021, according to preliminary estimates from the…
Headline
Six national organizations, including the AHA, today urged congressional leaders to permanently expand access to the Affordable Care Act’s advance premium tax…
Headline
In response to the ongoing pandemic and need to use telehealth and virtual care options, the Department of Health and Human Services will continue to include…
Blog
This blog post is adapted from a forthcoming white paper. Private commercial insurance is critically important to the millions of Americans who receive…
Headline
Researchers are taking an “off-base” approach to setting benchmarks for commercial insurance rates, and in the process wrongly painting hospitals as the source…