Competition in healthcare: more choice, better quality and…

Every American deserves access to affordable, comprehensive, high-quality coverage and care. But health care prices and costs continue to escalate year after year, making coverage and care less affordable for everyone. Now is the time to take action and drive strong competition in healthcare. Health insurance providers are committed to working together with hospitals, health systems and other health care leaders to provide all Americans with more health care choices and better quality at lower prices and 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 by the American Medical Association (AMA) says otherwise. The AMA’s conclusions and claims are simply false and wrong. 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 provides lower costs, more choices and better outcomes.

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

The facts are clear: MA works. MA markets have become more competitive over time. In the last decade:

  1. The average number of MA plans per county increased by 68%.
  2. The number of plans offering the convenience and value of integrated medical and prescription drug coverage (MA-PD) more than twice.
  3. The 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 goes for the commercial market. Nearly 20 million Americans buy health coverage on their own or through the Affordable Care Act exchanges. Exchange enrollment is growing thanks to American Savings Act premium subsidies, which help more than 90 percent of enrollees buy 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 continues to increase competition on 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 coverage to over 180 million Americans each year, and a large number of them are able to 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

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

Studies show that a lack of competition among providers and anticompetitive contracting practices create perverse incentives for hospitals and health systems to raise prices without improving patient value. In addition to the lack of quality improvement, a study in Health Services Research showed that hospital consolidation leads to lower patient satisfaction. Members of Congress have highlighted their concerns about anticompetitive contracting practices, and federal agencies have highlighted this as an area for further comment.

The bottom row

Here’s the bottom line: MA and the stock markets are excellent 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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