AMA 2024 Study Highlights High Concentration in U.S. Health Insurance Markets

The American Medical Association (AMA) has released its 2024 analysis of competition in U.S. health insurance markets, focusing on commercial and Medicare Advantage segments. The comprehensive study covers 384 metropolitan areas, all 50 states, and the District of Columbia, identifying the two largest insurers in each market. Using federal merger guidelines introduced in late 2023, the AMA assesses market concentration, flagging markets where limited competition may inflate costs and constrain consumer choices. This study underscores that most metropolitan areas remain highly concentrated, with one or two insurers dominating and thus limiting options for both patients and providers. AMA CEO Dr. John J. Whyte emphasizes the direct impact of insurer market dominance on rising premiums and restricted access to care. The report highlights the persistent challenges in fostering competition within the U.S. health insurance landscape. The insights within serve as a critical resource for policymakers, researchers, and regulators aiming to safeguard consumers and providers from anticompetitive practices. The likelihood of further consolidation should be scrutinized against the backdrop of already low competition levels in many insurance markets. For over two decades, the AMA's studies have informed antitrust advocacy, emphasizing the importance of regulatory measures that prevent harm from insurer mergers and acquisitions. The AMA continues to promote transparency and market scrutiny to ensure competition benefits both patients and physicians. The updated study and supplementary materials are accessible on the AMA's Competition in Health Care Research website for stakeholders interested in the ongoing dynamics of health insurance market concentration. This initiative reflects the AMA's broader role within the healthcare ecosystem, representing over 190 state and specialty medical societies. The AMA advocates for policies addressing barriers to patient care, chronic disease prevention, and broader public health objectives. Its focus on health insurance market competition aligns with its mission to enhance access, affordability, and quality of care through informed policy and regulatory actions.