The cities with the most competitive commercial insurance markets | 2023

Almost half of the nation's local commercial insurance markets are majority controlled by one payer, according to the American Medical Association. 

The AMA's annual "Competition in Health Insurance" report, published in December, found that 73% of metropolitan areas have "highly concentrated" commercial health insurance markets. In 90% of metropolitan areas, one payer has at least a 30% market share in combined HMO, PPO, point-of-sale and exchange markets. In 48% of markets, one insurer had a share of
50% or more.

These are the metro areas where the largest payer controls less than 30 percent of the market:

Providence-Warwick, R.I.-Mass.
BCBS Rhode Island: 22% market share

Hagerstown-Martinsburg, Md.-W.V.
CareFirst BCBS: 22% market share

Seattle-Tacoma-Bellevue, Wash.
Premera BCBS: 23% market share

Albany-Lebanon, Ore.
Cambia Health Solutions: 24% market share 

Eugene-Springfield, Ore.
PacificSource: 24% market share 

Grants Pass, Ore.
PacificSource: 25% market share

Washington-Arlington-Alexandria, D.C.-Va.-Md.-W.V.
CareFirst BCBS: 25% market share 

Denver-Aurora-Lakewood, Colo.
UnitedHealth Group: 25% market share

Portland-Vancouver-Hillsboro, Ore.-Wash.
Kaiser Permanente: 25% market share

Eau Claire, Wis.
Elevance Health: 25% market share

Janesville-Beloit, Wis.
Quartz: 25% market share

New York-Newark-Jersey City, N.Y.-N.J.-Pa.
UnitedHealth Group: 26% market share

Miami-Fort Lauderdale-Pompano Beach, Fla.
Florida Blue: 26% market share 

Carson City, Nev.
Elevance Health: 26% market share 

Springfield, Mass.
Baystate: 27% market share  

Boulder, Colo.
Elevance Health: 27% market share 

Colorado Springs, Colo.
Elevance Health: 27% market share 

Allentown-Bethlehem-Easton, Pa.-N.J.
Highmark: 27% market share 

Orlando-Kissimmee-Sanford, Fla.
Florida Blue: 28% market share

Poughkeepsie-Newburgh-Middletown, N.Y.
UnitedHealth Group: 28% market share

Salem, Ore.
Kaiser Permanente: 28% market share

Fond du Lac, Wis.
UnitedHealth Group: 28% market share  

Green Bay, Wis.
UnitedHealth Group: 28% market share

Wausau-Weston, Wis.
Elevance Health: 28% market share 

San Diego-Chula Vista-Carlsbad, Calif.
Kaiser Permanente: 29% market share

Pueblo, Colo.
Elevance Health: 29% market share

Palm Bay-Melbourne-Titusville, Fla.
Cigna: 29% market share

Kingston, N.Y.
UnitedHealth Group: 29% market share 

Fargo, N.D.-Minn.
BCBS North Dakota: 29% market share

Columbus, Ohio
Elevance Health: 29% market share

Toledo, Ohio
Elevance Health: 29% market share 

Weirton-Steubenville, W.V.-Ohio
Highmark: 29% market share

Medford, Ore.
Cambia Health Solutions: 29% market share

Yakima, Wash.
Premera BCBS: 29% market share 

Wheeling, W.V.-Ohio
Highmark: 29% market share