Remember how U.S. lawmakers on both sides of the aisle looked voters in the eye a few years ago and told them that they ‘didn’t need a public health care option’? Even though those usually wealthy lawmakers enjoy a socialized medical program — over 70% of which is subsidized by you, Mr. and Ms. Taxpayer — you simply couldn’t have the same reasonable option.
Socialized medicine is good enough for their medical care, but somehow not good enough for your own.
No, for you they created a wildly complicated set of market-based health insurance exchanges. Democrats called it the Affordable Care Act. Republicans called it ‘Obamacare’ — apparently assuming that voters would be scared to death of anything potentially created by a Black man.
Well guess what? It turns out that “the individual and small group markets generally became more concentrated in recent years,” and that “the median market share of the top three issuers in each market increased by 12 and 10 percentage points, respectively, from 2011 through 2020,” stated a recent Government Accountability Office (GAO) study on the matter.
That’s important, as “highly concentrated insurance markets may indicate less competition and could affect consumers’ choices of issuers and the premiums they pay,” according to the report.
So it appears that our private health care system is still broken. But we’re pretty sure you already knew that.
Below, the American Spark offers informative quotes from the GAO study:
“Historically, the market for private health insurance in the United States has been highly concentrated, meaning a small number of issuers enrolled most of the people in a given market.
“In November 2020, we reported that, from 2010 to 2018, three types of insurance markets—the large group market (coverage offered by large employers), the small group market (coverage offered by small employers), and the individual market (consisting mainly of coverage sold directly to individual consumers who lack access to group coverage)—were highly concentrated.
“We found that the three largest issuers in each of these markets held at least 80 percent of the market in most states from 2010 through 2018. Within the individual market, we reported similar concentration patterns for those issuers participating in the individual insurance exchanges—marketplaces operated by either the state or federal government (known as federally facilitated exchanges) that were required to be established in each state by the Patient Protection and Affordable Care Act (PPACA)—starting in 2015.
“Highly concentrated insurance markets may indicate less competition and could affect consumers’ choices of issuers and the premiums they pay.
“PPACA included a provision for us to conduct a study on competition and concentration in health insurance markets. This report describes changes in the concentration of enrollment among issuers in each state’s:
- Individual health insurance market, including the individual market exchange
- Small group health insurance market, and
- Large group health insurance market.”
What GAO Found
“In November 2020, GAO reported that, from 2010 through 2018, enrollment in private health insurance plans was concentrated, meaning a small number of issuers of those plans enrolled most of the people in a given market.
“Specifically, GAO considered a market concentrated in a state if three or fewer issuers held at least 80 percent of that market.
“GAO examined the individual (coverage sold directly to individuals), small group (coverage offered by small employers), and large group (coverage offered by large employers) markets and found that this pattern continued in 2019 and 2020. Specifically:
- Each of the three markets in 2020 was concentrated in at least 42 states (including the District of Columbia)
- The individual and small group markets generally became more concentrated in recent years. The median market share of the top three issuers in each market increased by 12 and 10 percentage points, respectively, from 2011 through 2020. With these increases, their median market share was at least 97 percent in both markets in 2020.
“GAO found similar patterns of high concentration across individual market exchanges. Exchanges, which are marketplaces where consumers can compare and select among insurance plans offered by participating issuers, were established by the Patient Protection and Affordable Care Act (PPACA).
“From 2015 through 2020, most states’ exchanges were concentrated and became more concentrated over time. This was often because the number of issuers decreased or the existing issuers increased their market share within a state. In 2020, the exchanges were concentrated in all states.
“GAO received technical comments on a draft of this report from the Department of Health and Human Services and incorporated them as appropriate.”
