20 metro areas with the least competitive commercial health insurance markets

The American Medical Association published its most recent edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets. The study contains 2013 data from 50 states, including Washington D.C., and 388 metropolitan areas.

Below are the 20 metropolitan areas with the least competitive commercial health insurance markets based on the market share of the dominant insurer. The AMA calculated market share in a geographic area by dividing an insurer's enrollment by the sum of all insurers' enrollment and multiplying the result by 100. The data refers to the combined HMO, PPO and POS markets.

Note: The rankings total 20, although the list includes ties, which means there are more than 20 markets listed.

1. Gadsden, Ala. — 91 percent (Blue Cross and Blue Shield of Alabama)

2. Decatur, Ala. — 88 percent (Blue Cross and Blue Shield of Alabama)

2. Dothan, Ala. — 88 percent (Blue Cross and Blue Shield of Alabama)

2. Florence, Ala. — 88 percent (Blue Cross and Blue Shield of Alabama)

2. Tuscaloosa, Ala. — 88 percent (Blue Cross and Blue Shield of Alabama)

3. Tallahassee, Fla. — 85 percent (Florida Blue)

4. Danville, Va. — 84 percent (WellPoint)

5. Anniston-Oxford, Ala. — 82 percent (Blue Cross and Blue Shield of Alabama)

5. Auburn-Opelika, Ala. — 82 percent (Blue Cross and Blue Shield of Alabama)

5. Huntsville, Ala. — 82 percent (Blue Cross and Blue Shield of Alabama)

5. Montgomery, Ala. — 82 percent (Blue Cross and Blue Shield of Alabama)

6. Birmingham-Hoover, Ala. — 80 percent (Blue Cross and Blue Shield of Alabama)

6. Ocean City, N.J. — 80 percent (Horizon Blue Cross Blue Shield of New Jersey)

7. Atlantic City, N.J. — 78 percent (Horizon Blue Cross Blue Shield of New Jersey)

8. Mobile, Ala. — 77 percent (Blue Cross and Blue Shield of Alabama)

9. Dover, Del. — 76 percent (Highmark Blue Cross Blue Shield Delaware)

9. Iowa City, Iowa — 76 percent (Wellmark Blue Cross and Blue Shield)

9. Greenville, N.C. — 76 percent (Blue Cross Blue Shield of North Carolina)

10. Ann Arbor, Mich. — 75 percent (Blue Cross Blue Shield of Michigan)

10. Battle Creek, Mich. — 75 percent (Blue Cross Blue Shield of Michigan)

10. Bay City, Mich. — 75 percent (Blue Cross Blue Shield of Michigan)

11. Lansing-East Lansing, Mich. — 74 percent (Blue Cross Blue Shield of Michigan)

12. Harrisonburg, Va. — 73 percent (WellPoint)

13. Goldsboro, N.C. — 72 percent (Blue Cross Blue Shield of North Carolina)

13. Erie, Pa. — 72 percent (Highmark)

13. Wenatchee, Wash. — 72 percent (Premera Blue Cross)

14. Sumter, S.C. — 70 percent (Blue Cross and Blue Shield of South Carolina)

15. Topeka, Kan. — 69 percent (Blue Cross and Blue Shield of Kansas)

15. Owensboro, Ky. — 69 percent (WellPoint)

15. Jackson, Mich. — 69 percent (Blue Cross Blue Shield of Michigan)

15. Rocky Mount, N.C. — 69 percent (Blue Cross Blue Shield of North Carolina)

16. Fairbanks, Alaska — 68 percent (Premera Blue Cross)

16. Yuba City-Marysville, Calif. — 68 percent (WellPoint)

16. Honolulu, Hawaii — 68 percent (Hawaii Medical Service Association, independent licensee of BCBS)

16. Anderson, Ind. — 68 percent (WellPoint)

16. Terre Haute, Ind. — 68 percent (WellPoint)

16. Detroit-Livonia-Dearborn, Mich. — 68 percent (Blue Cross Blue Shield of Michigan)

16. Monroe, Mich. — 68 percent (Blue Cross Blue Shield of Michigan)

16. Niles-Benton Harbor, Mich. — 68 percent (Blue Cross Blue Shield of Michigan)

16. Warren-Farmington Hills-Troy, Mich. — 68 percent (Blue Cross Blue Shield of Michigan)

16. Johnstown, Pa. — 68 percent (Highmark)

16. Casper, Wyo. — 68 percent (Cigna)

17. Altoona, Pa. — 67 percent (Highmark)

17. Blacksburg-Christiansburg-Radford, Va. — 67 percent (WellPoint)

18. Flint, Mich. — 66 percent (Blue Cross Blue Shield of Michigan)

18. Saginaw-Saginaw Township North, Mich. — 66 percent (Blue Cross Blue Shield of Michigan)

19. Gainesville, Fla. — 65 percent (Florida Blue)

19. Houma-Bayou Cane-Thibodaux, La. — 65 percent (Louisiana Health Services & Indemnity aka Blue Cross and Blue Shield of Louisiana)

19. Kalamazoo-Portage, Mich. — 65 percent (Blue Cross Blue Shield of Michigan)

19. Lynchburg, Va. — 65 percent (WellPoint)

20. Elkhart-Goshen, Ind. — 64 percent (WellPoint)

20. Bismarck, N.D. — 64 percent (Aetna)

20. Anderson, S.C. — 64 percent (Blue Cross and Blue Shield of South Carolina)

20. Columbia, S.C. — 64 percent (Blue Cross and Blue Shield of South Carolina)

20. Spartanburg, S.C. — 64 percent (Blue Cross and Blue Shield of South Carolina)

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