Staff Reporter

In recent years, the health insurance industry has seen a wave of significant mergers and acquisitions, concentrating power in the hands of a few dominant firms. This consolidation has resulted in fewer choices for Americans seeking health coverage.

In 2018, CVS Health acquired Aetna, while Cigna purchased Express Scripts. More recently, in 2023, Kaiser Permanente merged with Geisinger.

As of 2023, just four health insurers command an impressive 50% of the market, and six companies account for 30% of all healthcare spending in the United States.

Although these mergers have led to increased profits for these firms, they have also, in some cases, driven up premiums for consumers.

Here’s a look at the largest health insurance companies and their market shares:

• Centene, Blue Shield of California, Blue Cross Blue Shield of Michigan, and BCBS of Florida — 2% each.  Each of these companies holds 2% of the market.

• Kaiser Permanente — 7%
  Following its merger with Geisinger in 2023, Kaiser Permanente has a market share of 7%.

• Health Care Service Corporation — 7%
  HCSC, which generated $54 billion in revenue in 2023, also controls 7% of the market.

• Cigna — 11%                     
• After acquiring Express Scripts, Cigna now holds 11% of the market.
• CVS Health (Aetna) — 12%
  As the parent company of Aetna, CVS Health controls 12% of the market.

• Elevance Health — 12%
  Previously known as Anthem, Elevance Health ranks second with a 12% market share.
• UnitedHealth Group — 15%
  As the largest health insurance company in the U.S., UnitedHealth Group, which oversees United Healthcare, has a market cap exceeding $500 billion and serves more than 29 million Americans, controlling 15% of the market.