The culmination of years of consolidation among health insurers is restricting competition in four out of five metropolitan areas in the United States, new analysis from the
The 2011 edition of "Competition in Health Insurance: A Comprehensive Study of U.S. Markets," analyzes commercial health insurance market shares and federal concentration measures for 368 metropolitan markets and 48 states. The study found a significant absence of health insurer competition exists in 83 percent of metropolitan markets studied by the AMA. Indeed, in about half of metropolitan markets, at least one health insurer had a commercial market share of 50 percent or more, and in 24 of the 48 states in study, the two largest health insurers had a combined commercial market share of 70 percent or more. In order, the 10 states with the least competitive commercial health insurance markets are: Alabama, Alaska, Delaware, Michigan, Hawaii, District of Columbia, Nebraska, North Carolina, Indiana and Maine.
“New data presented by the AMA demonstrates the degree of anti-competitive market clout that some health insurers have gained through mergers and acquisitions,” said AMA President Peter W. Carmel, M.D. “Our new report 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.”
For insurers, the numbers raise anti-trust implications. The study notes that the 83 percent of markets rated “highly concentrated,” were done so based on the newly revised "Horizontal Merger Guidelines" issued last year by the
