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Competition in healthcare: more choices, better quality, and…

Every American deserves access to affordable, comprehensive coverage and high-quality care. But health care prices and costs continue to rise year after year, making coverage and care less accessible to everyone. Now is the time to take action and encourage strong competition in healthcare. Health insurance providers are committed to working with hospitals, health systems and other health care leaders to offer all Americans more health care choices and better quality at lower prices and lower costs.

Competition among health insurance providers and the plans they offer remains strong – offering American families more choices and better value than ever before. But a recent report from the American Medical Association (AMA) claims otherwise. The AMA’s conclusions and assertions are simply false and incorrect. Let’s look at the facts.

Focus on MA

More than 29 million seniors and people with disabilities choose Medicare Advantage (MA) because it provides better services, better access to care and better value. They know that MA delivers lower costs, more choices and better outcomes.

MA was designed as a public-private partnership to provide choices to original Medicare, and to use private market competition to deliver better care at lower costs for seniors and taxpayers.

The facts show clearly: MA works. MA markets have become more competitive overtime. Over the past decade:

  1. The average number of MA plans per country increased by 68%.
  2. The number of plans that offer the convenience and value of integrated medical and prescription drug coverage (MA-PD). more than doubled.
  3. The vast majority of Americans eligible for Medicare have access to a $0 premium plan with drug coverage.
  4. The number of companies competing in the MA space increased by 15%.

Focus on commercial markets

The same is true in the commercial market. Nearly 20 million Americans buy health care coverage on their own or through the Affordable Care Act’s exchanges. Exchange enrollment is growing thanks to the American Savings Plan Act’s premium subsidies, which help more than 90% of enrollees purchase affordable coverage that covers essential health benefits and prescription drugs without exclusions for pre-existing conditions or annual or lifetime limits.

The demand for high-quality, low-cost health plans has continued to increase competition in the exchanges. For 2022, health insurance providers have expanded offerings, with more than 200 companies offering coverage through the marketplaces. Consumers have more choices with access to an average of 6 to 7 qualified health plan (QHP) issuers and more than 100 plans to choose from in every state – more than ever before.

Employer coverage also provides valuable health care coverage for more than 180 million Americans each year, and a large majority can participate in a health plan and are satisfied with their coverage. Today, more than 90% of all American workers are employed by a company that offers benefits, and more than 70% of Americans are satisfied with their current employer-provided coverage.

Competition among suppliers

AMA is right about one thing: It is becoming increasingly difficult to build robust networks to meet the needs of seniors and people with disabilities. And this is directly caused by less and less competition between hospitals, health care systems and doctors.

Studies show that the lack of competition between providers and anti-competitive contracting practices create perverse incentives for hospitals and health care systems to raise prices without improving value for patients. In addition to no quality improvement, a study in Research on health services showed hospital consolidation leads to lower patient satisfaction. Members of Congress have highlighted concerns about anti-competitive contracting practices and federal agencies have highlighted this as an area for additional comment.

The Bottom Line

Here’s the bottom-line truth: MA and the Exchange marketplaces are prime examples of government and the free market working together to deliver lower costs, more choices, and better outcomes for the American people. That’s why America’s health insurance providers stand firm in their commitment to protect and strengthen these markets for the millions of Americans who depend on them.

Americans need and deserve more affordable health care choices than ever before. We invite the AMA to work with us on real solutions to achieve these important goals.

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