News: Vast majority of U.S. health insurance markets ‘highly concentrated,’ report suggests

Ninety-seven percent of commercial health insurance markets in the United States were “highly concentrated,” according to a new report from the American Medical Association (AMA).

The report sought to examine:

• Whether health insurance markets are competitive or health insurers possess market power
• Whether proposed mergers involving insurers are likely to create, enhance or entrench market power

To this end, the authors examined 2024 data from Decision Resources Group, the most comprehensive and consistent source of data on health insurance enrollment. This data contained information for 384 metropolitan statistical areas (MSA) across the U.S.

According to the authors, not only were 97% of MSA-level commercial markets highly concentrated in 2024, but, also, “91% of MSA-level markets, at least one insurer had a commercial market share of 30% or greater, and in 47% of markets, a single insurer’s share was at least 50%.”

In the conclusion of their study, the authors emphasized the harmful effect this type of economic structure can have on public health and patient care.

“[H]ealth insurers,” they concluded, “are exercising marketpower in many parts of the country and, in turn, causing competitive harm to consumers of health insurance and to consumers and providers of care.”

Editor’s note: To read the American Hospital Association summary, click here. To read the AMA report, click here.