What's Happening?
The American Medical Association (AMA) has released a report detailing the concentration levels in the U.S. health insurance markets, both in commercial insurance and Medicare Advantage (MA). The report indicates
that UnitedHealth Group, Elevance Health, and Aetna are leading in market share. UnitedHealth Group holds the largest individual share in the commercial market at 16%, while Blue Cross Blue Shield (BCBS) plans collectively control 43% of the market. In Medicare Advantage, UnitedHealth also leads with a 30% market share. The report highlights that 97% of metro commercial insurance markets were concentrated in 2024, a slight increase from 95% in 2014. Similarly, 97% of MA markets were concentrated in 2024, though this is a decrease from 99% in 2017. The AMA emphasizes that this concentration leaves patients with fewer choices and higher costs.
Why It's Important?
The concentration in health insurance markets has significant implications for consumers, as it can lead to higher premiums and fewer options for coverage. The dominance of a few large insurers may stifle competition, potentially resulting in less innovation and poorer service quality. For policymakers, these findings could prompt discussions on regulatory measures to enhance competition and protect consumer interests. The AMA's report underscores the need for a competitive market to ensure affordable and accessible healthcare, which is a critical issue in the U.S. healthcare system.
