Blue Cross Blue Shield of Alabama has more than 90% of the commercial and exchange insurance market share in three cities in the state, the most highly concentrated markets in the U.S., according to the American Medical Association.
The group published its annual "Competition in Health Insurance" report in December. According to the organization, 73% of metropolitan areas have "highly concentrated" markets, meaning one payer controls more than 30% of the commercial and exchange market.
Of those, 41 cities' markets are dominated by one insurer with a more than 70% market share.
Here are the least competitive commercial insurance markets:
1. Anniston-Oxford, Ala.
BCBS Alabama: 92%
1. Gadsden, Ala.
BCBS Alabama: 92%
3. Tuscaloosa, Ala.
BCBS Alabama: 91%
4. Dothan, Ala.
BCBS Alabama: 89%
4. Florence-Muscle Shoals, Ala.
BCBS Alabama: 89%
4. Montgomery, Ala.
BCBS Alabama: 89%
7. Decatur, Ala.
BCBS Alabama: 88%
8. Huntsville, Ala
BCBS Alabama: 85%
8. Mobile, Ala.
BCBS Alabama: 85%
10. Auburn-Opelika,Ala.
BCBS Alabama: 84%
10. Tallahassee, Fla.
BCBS Florida: 84%
12. Birmingham-Hoover, Ala.
BCBS Alabama: 83%
13. Ann Arbor, Mich.
BCBS Michigan: 81%
13. Daphne-Fairhope-Foley, Ala.
BCBS Alabama: 81%
15. Atlantic City-Hammonton, N.J.
Horizon BCBS: 79%
15. Rochester, N.Y.
Lifetime Healthcare: 79%
15. Goldsboro, N.C.
BCBS North Carolina: 79%
18. New Bern, N.C.
BCBS North Carolina: 78%
19. Panama City, Fla.
BCBS Florida: 76%
19. Manhattan, Kan.
BCBS Kansas: 76%
19. Bay City, Mich.
BCBS Michigan: 76%
19. Monroe, Mich.
BCBS Michigan: 76%
19. Ocean City, N.J.
Horizon BCBS: 76%
24. Battle Creek, Mich
BCBS Michigan: 75%
24. Jackson, Mich.
BCBS Michigan: 75%
24. Lawton, Okla.
HCSC: 75%
27. Topeka, Kan.
BCBS Kansas: 74%
27. Lansing-East Lansing, Mich.
BCBS Michigan: 74%
27. Greenville, N.C.
BCBS North Carolina: 74%
27. Jacksonville, N.C.
BCBS North Carolina: 73%
31. Vallejo, Calif.
Kaiser Permanente: 73%
31. Midland, Mich.
BCBS Michigan: 73%
31. Niles, Mich.
BCBS Michigan: 73%
34. Lexington-Fayette, Ky.
Elevance Health: 72%
34. Lake Charles, La.
BCBS Louisiana: 72%
34. Flint, Mich.
BCBS Michigan: 72%
37. Decatur, Ill.
HCSC: 71%
37. Detroit-Warren-Dearborn, Mich.
BCBS Michigan: 71%
37. Rocky Mount, N.C.
BCBS North Carolina: 71%
40. Owensboro, Ky.
Elevance Health: 70%
40. Gainesville, Fla.
BCBS Florida: 70%