U.S. health and medical insurance market to 2026: major insurers account for $ 130 billion



DUBLIN, November 19, 2021 / PRNewswire / – The “United States Health and Medical Insurance Market – Growth, Trends, Impact of COVID-19 and Forecast (2021 – 2026)” the report was added to ResearchAndMarkets.com‘s offer.

The US health insurance market is the largest in the world, without adhering to the WHO universal health coverage.

Although 8% of the American population does not have health insurance, United States continues to dominate health insurance premium growth in North America. This growth can be attributed to medical inflation, increased employment, and some postponement of benefits from the old United States. President Obama’s and Trump’s health policies.

According to cdc.govCenter for Disease Control and Prevention, United States spent $ 3.8 trillion in 2019, nearly 17.7% of the country’s GDP, which represents the average expenditure per person on health in United States To 11,582 USD who crossed the 12,000 USD mark in 2020. The United States government has established extensive health care laws to provide health coverage to the majority of the American population.

According to the NAIC (National Association of Insurance Commissioners), over 68% of healthcare coverage was provided by private insurance programs, such as PPOs, HMOs, POS plans, etc.

The main insurers of United States represented approximately 130 billion dollars in 2019, over 60% of which came from the top 25 health insurers. About 6% of Americans have non-group health insurance, and 50% have employer-provided insurance, 35% have Medicaid or Medicare and Military insurance while over 9% are still uninsured in 2019 .

Drivers: Highlights

  • Increase in total health expenditure, which includes both public and private expenditure on health promotion and disease prevention programs, with the use of medical, paramedical and nursing knowledge and technology
  • Overall employment growth increases demand for health insurance through individual and employer-sponsored health coverage

Constraints: highlights

  • Government regulations and related political orders are making many unprecedented changes in the way health care coverage is offered to U.S. citizens.
  • Expensive health insurance and even expensive treatment have seen no improvement, even after repeated state intervention due to the heavily privatized sector.

Key market trends

High deduction health plans are gaining popularity with the public

These are plans with a higher deductible than any traditional insurance plan. The monthly premium is usually lower, but more health care costs are paid before the insurance company starts paying its share (your deductible). A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing you to pay for certain medical expenses with money without federal tax.

The IRS defines a high-deductible health plan as any plan with a deductible of at least $ 1,350 for an individual, or $ 2,700 for a family. The total annual expenses of an HDHP (including deductibles, co-payments and coinsurance) cannot exceed $ 6,650 for an individual, or 13,300 USD for a family (does not apply to off-grid services).

The number of registrations for these plans continues to grow year over year as many employees feel the need to fight rising healthcare prices. Growing consumerization can continue to drive the huge growth of voluntary benefits among employees, and as a result, HDHPs are gaining in popularity, in order to manage costs.

The large group market with more than 50 employees remains the most popular setting for HDHP and HAS registration, according to AHIP. In 2017, 82% of registrations took place with large employers, followed by the small employer market (11%) and the personal market (7%).

ACA and Health

0.7 million people were covered by the health insurance markets created under the ACA, including 9.2 million who received premium tax credits and 5.3 million who received reductions cost sharing. In Florida, Mississippi, Alabama, Nebraska and Oklahoma, at least 95% of market registrants receive premium tax credits and / or cost-sharing grants.

Insurers can no longer deny coverage for pre-existing conditions, charge higher premiums based on health or gender, revoke coverage when someone becomes ill, or impose annual or lifetime limits. About 54 million people have a pre-existing condition that could have barred them from coverage in the pre-ACA individual market. Private insurers must now cover a wide range of preventive services at no cost to consumers. This includes recommended cancer and chronic disease screenings, vaccinations and other services. Almost 150 million people are affiliated with employer plans or individual market insurances which must provide these preventive services free of charge.

Insights on Private health insurance (PHI) in United States

According to United States Census Bureau, in 2018, private health insurance coverage stood at 68%, significantly higher than government coverage (32%).

In the different segments of health insurance coverage, employer-based insurance was the most common, which covered about 56% of the population for a few months, or all year, followed by Medicaid (19.3 %), Medicare (17.2%), direct purchase coverage (16.0%) and military coverage (4.8%).

Growth in private health insurance spending is expected to have increased by 0.5%, to 5.6%, in 2017, in part due to higher premiums in the health insurance market. However, spending is expected to slow by 0.7%, on average, for 2019-2020

Competitive landscape

According to a report by the American Medical Association (or AMA), the private health insurance sector is highly concentrated, with 72% of the total metropolitan areas not having significant competition among health insurers.

The Henry J. Kaiser Family Foundation measured the competitiveness of the private health insurance market in 2013, using the Herfindahl-Hirschman (HHI) index as an indicator.

The HHI takes into account the share of a market controlled by each of the competing companies (market share) and is expressed by a value between zero and 10,000. The lower the number, the more the market. competitive. The higher concentration of mergers and acquisitions of various health insurers is expected to raise antitrust concerns among consumers. This is a result of the health insurer’s monopoly power, due to consolidation, which gives them leverage to raise and keep premiums above competitive levels.

Main topics covered:

Market Snapshot
Dissertation on Medicare Premiums and Study on the Effect of Medical Trend Rate on Medicare Plans
Overview of online sales growth of Health insurance and growth prospects in the health insurance sector
Technological advancement and innovation in the health insurance sector
Government regulations and initiatives
Brief on the Patient Protection and Affordable Care Act (ACA, Trumpcare) and its implications for comprehensive health insurance coverage
Insights on the latest health policy changes and their effect on the health spending of U.S. citizens
Market factors
Market constraints
Porters 5 Force Analysis
The threat of new participants
Bargaining power of buyers / consumers
Bargaining power of suppliers
Threat of substitute products
Intensity of competitive rivalry
Impact of Covid-19 on the US Medicare and Medicare Market.




Companies mentioned

  • UnitedHealth Group
  • Anthem
  • Humana Group
  • Healthcare Services Group Inc.
  • Centene Company
  • Aetna Inc.
  • Kaiser Foundation Group
  • Independence Health Group
  • Molina Health

For more information on this report, visit https://www.researchandmarkets.com/r/whzde5

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