Insurance Giants Tighten Grip on US Market

The American Medical Association (AMA) recently published its Competition in Health Insurance: A Comprehensive Study of U.S. Markets report. In its finding, the AMA concluded that in 2024 in the vast majority of metropolitan areas across the country, one or two health insurers hold oversized market shares. "When one or two companies call the shots, premiums rise, options shrink, and patients suffer," states AMA CEO and Executive Vice President John Whyte, MD, MPH. The report found that in:

Commercial markets

• nationally, Blue Cross Blue Shield insurers (collectively) captured 43% of the market.

• Blue Cross Blue Shield holds the largest market share in 84% of metropolitan areas.

• A lack of competition has spread over the last decade with 97% of metropolitan areas deemed "highly concentrated" according to federal guidelines.

• The 10 least competitive states, in order, were Alabama, Kentucky, Hawaii, Michigan, Louisiana, Illinois, Alaska, Vermont, Delaware, and West Virginia.

Medicare Advantage markets

• Competition slightly improved in the last 7 years as fewer local markets were highly concentrated.

• UnitedHealth Group had the largest market share in 44% of metropolitan areas.

• The 10 least competitive states, in order, were Wyoming, District of Columbia, Rhode Island, Montana, Nebraska, Utah, West Virginia, Mississippi, Oklahoma, and Louisiana.

For the full report, click here.