(Credit score: GAO)
The extent of competitors within the U.S. industrial medical insurance market has dwindled since 2010, when the Inexpensive Care Act (ACA) got here to life.
Analysts on the GAO have revealed information supporting that conclusion in a brand new personal medical insurance market focus examine.
The analysts ready the report due to an ACA provision that requires the GAO to transient Congress on medical insurance market focus each two years. ACA drafters hoped the brand new packages and subsidies created by the brand new regulation, such because the ACA public exchange program, and the Shopper Operated and Oriented Plan Program, would minimize the price of well being protection, and enhance the standard, by growing the extent of competitors.
A duplicate of the GAO evaluation of personal medical insurance market focus is accessible right here.
An article about an American Medical Affiliation evaluation of competitors within the industrial medical insurance sector is accessible right here.
The analysts who ready the brand new report look solely on the interval from 2011 by 2018, for all 50 states and the District of Columbia.
For some sections of the report, they use information from HealthCare.gov, the company that operates ACA public exchange providers for states which might be unwilling or unable to arrange their very own ACA public exchange packages. The analysts don’t look immediately on the influence of HealthCare.gov or different ACA packages, or on the results of efforts by members of Congress and the administration of President Donald Trump to restrict or shut down ACA subsidy packages.
The GAO analysts outlined a market as being extremely concentrated if the highest three issuers available in the market accounted for 80% or extra of the enrollment in that market.
Within the particular person main medical insurance coverage market, for instance, in 2011, 33 of the 51 jurisdictions studied had extremely concentrated markets.
The variety of extremely concentrated markets elevated to 41 in 2014, when the ACA exchange market got here to life.
The variety of extremely concentrated markets fell to 37 in 2015 and 2016, elevated to 39 in 2017, after which rose to 46 in 2018.
The extent of market focus elevated probably the most in Indiana, Washington state and Texas and decreased probably the most in Ohio, Colorado and Kansas, in accordance with the GAO analysts.
Equally, the variety of jurisdictions with extremely concentrated small-group main medical insurance coverage markets elevated to 46 in 2018, from 36 in 2011.
Within the large-group market, the variety of extremely concentrated jurisdictions elevated to 43, from 40.
The American Medical Affiliation (AMA) revealed a separate evaluation of competitors within the medical insurance market in October.
The AMA analysts used one other measure of market focus, Herfindahl-Hirschsprung Index (HHI) scores.
HHI scores can vary from 0, for a market with an infinite stage of competitors, as much as 10,000, for a market the place one participant captures all share.
The AMA discovered that the median 2019 HHI market focus rating for all the nation was 3,176. That was down from 3,211 in 2018, and down from 3,276 in 2008. The AMA figures point out that the general U.S. industrial medical insurance market focus stage was somewhat decrease in 2019 than in 2018 or in 2008.
The hole between the AMA numbers and the GAO numbers may very well be due partly to the truth that the analysts calculated market concentrations stage for various units of years.
— Learn Economist: Hospital, Payer Consolidation Hurting Market, on ThinkAdvisor.
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