The American Medical Association (AMA) says most U.S. commercial health insurance markets are "highly concentrated."
The AMA, Chicago, says at least one insurer has a market share of 50% or more in 48% of U.S. metropolitan statistical areas.
In 99% of the markets, the health insurance market meets the definition of "highly concentrated" that the U.S. Department of Justice and the Federal Trade Commission set in 1997, the AMA says.
The AMA argues that health insurer concentration helps insurers dominate physicians in an unfair way.
Health insurers traditionally have argued that they need substantial market clout to bargain for reasonable prices from physicians and hospitals.
In another look at large health plans, Mark Farrah Associates, Kennebunk, Maine, is reporting that health plan enrollment at the 7 largest U.S. health carriers increased 0.3% between September 2009 and September 2010, to about 126 million.
Health plan watchers have argued that the new Affordable Care Act – the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) – could encourage employers to avoid some Affordable Care Act requirements by self-insuring.
In 2010, enrollment in self-insured, "administrative services only" plans actually fell slightly, and enrollment in fully insured arrangements increased, Mark Farrah says.
Commercial enrollment at the carriers fell 1.1%; enrollment in Medicare plans, Medicaid plans and other government and government-related plans increased.
The Mark Farrah study includes Aetna Inc., Hartford (NYSE:AET); CIGNA Corp., Philadelphia (NYSE:CI); Health Care Service Corp., Chicago; Humana Inc., Louisville, Ky. (NYSE:HUM); Kaiser Permanente, Oakland, Calif.; UnitedHealth Group Inc., Minnetonka, Minn. (NYSE:UNH); and WellPoint Inc., Indianapolis (NYSE:WLP).
- Allison Bell
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