Lack of Competition in 80 Percent of Metropolitan Health Insurance Market

A new study from the Chicago, Ill.-based American Medical Association (AMA) says 80 percent of metropolitan areas in the United States lack a competitive commercial health insurance market.

According to the AMA’s President, Peter W. Carmel, M.D., the creation of those anti-competitive markets came about through mergers and acquisitions. The report, Competition in Health Insurance: A Comprehensive Study of U.S. Markets, is intended to help regulators, lawmakers, researchers and policymakers identify markets where mergers among health insurers may cause competitive harm to patients, physicians and employers.

The latest version is the most comprehensive analysis of its kind, reporting commercial health insurance market shares and federal concentration measures for 368 metropolitan markets and 48 states. The scope of the analysis provides analysis of fully-insured and self-insured enrollments for both health maintenance organizations and preferred provider organizations.

Other findings from the report are that in about half of metropolitan markets, at least one health insurer had a commercial market share of 50 percent or more. In 24 of the 48 states, the two largest health insurers had a combined commercial market share of 70 percent or more.

The 10 states with the least competitive commercial health insurance markets according to the AMA are: 1. Alabama, 2. Alaska, 3. Delaware, 4. Michigan, 5. Hawaii, 6. District of Columbia, 7. Nebraska, 8. North Carolina, 9. Indiana and 10. Maine.