United States Health and Medical Insurance Market 2021-2026: More than 68% of Coverage Provided by Private Insurance Programs - ResearchAndMarkets.com

DUBLIN--()--The "United States Health and Medical Insurance Market - Growth, Trends, COVID-19 Impact, and Forecasts (2021 - 2026)" report has been added to ResearchAndMarkets.com's offering.

The US healthcare insurance market is the largest in the world, without adhering to WHO's Universal Health Coverage.

Although 8% of the US population does not have a health insurance, the United States continues to top the growth in health premiums in North America. This growth can be attributed to medical inflation, increasing employment, and some carry-over of the benefits from the former US President Obama's and Trump's healthcare policies.

According to cdc.gov - Centre for Disease Control and Prevention, the United States spent USD 3.8 trillion in 2019 almost 17.7% of the country's GDP making the average per person expenditure on health in the United States at USD 11,582 which crossed the USD 12,000 mark in 2020. The US government has laid down numerous health care legislations, to provide health cover to a majority of US population.

According to the NAIC (National Association of Insurance Commissioners), more than 68% of health care coverage was provided by private insurance programs, such as PPOs, HMOs, POS plans, etc.

The leading 25 insurers in the United States accounted for about USD 130 billion in 2019, of which more than 60% came from top 25 health insurers. About 6% of Americans purchase health insurance in the non-group type, and 50% have insurance provided by the employer, 35% have insurances from Medicaid or Medicare and Military whereas over 9% remain uninsured as of 2019.

Drivers: Key Highlights

  • Increase in the total health expenditure, which includes both public and private spending on the programs that promote health and prevent disease, with the utilization of medical, paramedical, and nursing knowledge and technology
  • Growth in the overall employment increases the demand for health insurance through both individual and employer-sponsored health coverage

Restraints: Key Highlights

  • Government regulations and related policy orders effecting a lot of unprecedented changes in the way healthcare coverage is being offered to the American citizens.
  • The expensive healthcare insurance and an even expensive treatment did not see any improvement even after repeated state intervention due to the highly privatized sector.

Key Market Trends

High Deduction Health Plans Gaining Popularity among Public

These are plans with a higher deductible than any traditional insurance plan. The monthly premium is usually lower, but one pays more health care costs themselves before the insurance company starts to pay its share (your deductible). A high deductible plan (HDHP) can be combined with a health savings account (HSA), allowing one to pay for certain medical expenses with money free from federal taxes.

The IRS defines a high deductible health plan as any plan with a deductible of at least USD 1,350 for an individual, or USD 2,700 for a family. An HDHP's total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) cannot be more than USD 6,650 for an individual, or USD 13,300 for a family (does not apply to out-of-network services).

The enrollment number for these plans continues to grow YoY, as many employees feel the need to combat the rising healthcare prices. Rising consumerization may continue to drive the tremendous growth of voluntary benefits among employees, and therefore, the HDHPs are gaining popularity, in order to manage costs.

The large group market with more than 50 employees remains the most popular setting for HDHP and HAS enrollment, according to AHIP. In 2017, 82% of enrollment occurred in large employer settings, followed by the small-employer market (11%) and the individual market (7%)

The ACA and Health care

0.7 million people were enrolled in coverage through the health insurance marketplaces created under the ACA, including 9.2 million who received premium tax credits and 5.3 million who got cost-sharing reductions. In Florida, Mississippi, Alabama, Nebraska and Oklahoma, at least 95% of marketplace enrollees receive premium tax credits and/or cost-sharing subsidies.

Insurers can no longer deny coverage for pre-existing conditions, charge higher premiums based on health status or gender, revoke coverage when someone gets sick or impose annual or lifetime limits.

About 54 million people have a pre-existing condition that could have resulted in them being denied coverage in the pre-ACA individual market. Private insurers now must cover a wide range of preventive services at no out-of-pocket costs to consumers. This includes recommended cancer and chronic condition screenings, immunizations, and other services. Nearly 150 million people are enrolled in employer plans or through individual market insurance that must provide these free preventive services.

Companies Mentioned

  • UnitedHealth Group
  • Anthem
  • Humana Group
  • HealthCare Services Group Inc.
  • Centene Corporation
  • Aetna Inc.
  • Kaiser Foundation Group
  • Independence Health Group
  • Molina Healthcare

For more information about this report visit https://www.researchandmarkets.com/r/uwmzhy

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Contacts

ResearchAndMarkets.com
Laura Wood, Senior Press Manager
press@researchandmarkets.com
For E.S.T Office Hours Call 1-917-300-0470
For U.S./CAN Toll Free Call 1-800-526-8630
For GMT Office Hours Call +353-1-416-8900