The American Medical Association (AMA) released its annual report on health insurance competition on December 16, revealing a concerning trend of increased market concentration. The report found that 97% of commercial health insurance markets were highly concentrated in 2024. Specifically, in 91% of metropolitan statistical areas (MSAs), at least one insurer controlled 30% or more of the commercial market.
In nearly half of these areas, 47%, one insurer commanded at least 50% of the market share.
The findings for Medicare Advantage (MA) insurance were similarly alarming, with 97% of MA markets also being classified as highly concentrated. In 90% of MSAs, one insurer held 30% or more of the MA market share. Furthermore, in 24% of MSAs, a single insurer controlled at least half of the MA market.
These figures reflect a growing trend of limited competition, with fewer companies controlling larger portions of both commercial and MA insurance markets.
Blue Cross Blue Shield plans emerged as the dominant player in many commercial markets, with Elevance holding the largest share at 21%. In the Medicare Advantage sector, UnitedHealth Group was the leader, commanding the largest market share in 44% of MSAs. This consolidation of market power raises concerns about competition, pricing, and the potential impact on consumers’ access to affordable insurance options.
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