WellPoint Dominates the Market

WellPoint Inc. has a bigger geographic footprint than any other private health insurer in the United States, according to a study by the American Medical Association (AMA). WellPoint, soon to be renamed “Anthem,” is the largest health insurer, by market share, in 82 of 388 metropolitan areas examined by the AMA. WellPoint’s commanding position stretches across metropolitan markets in 13 states including: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, Ohio, Virginia and West Virginia. Health Care Service Corp. was second with a market share lead in 37 metropolitan areas, followed by UnitedHealth Group (UNH) with a market share lead in 35 metropolitan areas.

AMA President Robert M. Wah, M.D. said, “The AMA is greatly concerned that a single health insurer had at least a 50% share of the commercial health insurance market in 41% of metropolitan areas. The dominant market power of big health insurers increases the risk of anti-competitive behavior that harms patients and physicians, and presents a significant barrier to the market success of smaller insurance rivals.” The study also reveals the following:

  • There was a significant absence of health insurer competition in 72% of the metropolitan areas studied.
  • Seventeen states had a single health insurer with a commercial market share of 50% or more.
  • Forty-five states had two health insurers with a combined commercial market share of 50% or more.
  • The 10 states with the least competitive commercial health insurance markets were:
    1. Alabama, 2. Hawaii, 3. Michigan, 4. Delaware, 5. Louisiana, 6. South Carolina, 7. Alaska, 8. Illinois, 9. Nebraska, and 10. North Dakota. Illinois has made its first appearance in the annual AMA list, displacing Rhode Island from last year’s list. Louisiana entered the top 5, moving from 9th on last year’s list.
  • The 10 states that experienced the biggest drop in competition levels between 2011 and 2012 were: 1. Illinois, 2. Louisiana, 3. Indiana, 4. New Jersey, 5. New Hampshire, 6. Vermont, 7. Montana, 8. Wyoming, 9. Idaho, and 10. Tennessee.

Last Updated 08/10/2022

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