Private Health Insurance: Market Concentration in 2024 Was Generally Higher Than in 2011

GAO's state-level analysis finds private health insurance markets remained concentrated in 2024 compared with 2011, with most enrollees choosing among a small number of insurers. Its interactive data lets readers compare individual, small-group and large-group markets across states.

The report also records a countertrend: individual-market concentration eased somewhat between 2020 and 2024. Concentration can weaken consumer choice and bargaining, but the report describes market structure rather than estimating the causal effect on premiums or care quality.