10 states with least competitive commercial insurance markets

Alabama has the most concentrated commercial health insurance market in the U.S., making it the state with the least competitive market, according to a Nov. 1 analysis from the American Medical Association. 

For the 2022 study of U.S. health insurance markets, researchers with AMA analyzed market concentration in 383 metropolitan statistical areas, 50 states and Washington, D.C., according to the report. The researchers used the Herfindahl-Hirschman Index, a commonly accepted measure of concentration used in federal antitrust cases, to analyze competitiveness. 

Here are the 10 states with the least competitive commercial health insurance markets:

1. Alabama 

2. Michigan

3. Louisiana

4. Hawaii

5. South Carolina 

6. Kentucky 

7. Alaska 

8. Illinois 

9. Vermont

10. Delaware

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