AMA: 95% of U.S. Lacks Health Insurance Competition

Blue Cross and Blue Shield of Illinois continues to dominate Chicago’s commercial health insurance plan market with 61% share
By Bruce Japsen

ESCALATING consolidation in the health insurance industry has led to 95% of the commercial markets being “highly concentrated,” threatening patient choice of physicians and contributing to higher costs, according to a new report.

The latest edition of the American Medical Association’s “Competition in Health Insurance: A Comprehensive Study of U.S. Markets,” looked at 382 metropolitan statistical areas (MSAs), including the Chicago area, which is not only considered highly concentrated by the AMA but also poised for even more consolidation in 2025, if pending mergers come together. The markets exceeded a regulatory threshold set by federal guidelines and were considered “highly concentrated” and therefore lacked adequate competition, the AMA said. 

“Dominant health insurers in the vast majority of metropolitan areas across the United States have consolidated significant market share and driven away competition, leaving consumers in local markets with a decade of very limited options for medical coverage,” the AMA said in releasing the 2024 analysis, which tabulated commercial and Medicare Advantage market shares for the two largest health insurance companies in each geographic market studied between 2014 and 2023.

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