GAO
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There may be several companies selling health insurance in a given market, but we’ve previously found that most people generally enroll with one of a few companies. When that happens, it can mean less competition and higher premiums for that area.

We updated our work with more recent private insurance data. The overall story is similar: The 3 largest companies held 80% or more of the market in at least 37 states.

Available data on the Affordable Care Act insurance exchanges had similar trends. Three or fewer companies held 80% or more of the market in at least:

  • 46 of 49 exchanges for individuals
  • 42 of 46 exchanges for small employers

GAO
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