The 7 biggest health insurance companies that control almost 75% of the market

Over the past few years the health insurance industry has experienced a series of major mergers and acquisitions, further consolidating power into the hands of a few dominant companies — leaving Americans with fewer options.

In 2018, CVS Health $CVS (CVS) acquired Aetna. That same year Cigna $CI (CI) bought Express Scripts and in 2023, Kaiser Permanente merged with Geisinger.

As of 2023, just four health insurers control a staggering 50% of the market, while six companies account for 30% of all healthcare spending in the United States.

While these mergers have boosted profits for these companies, they also, in some cases, raised premiums for consumers.

Here is a ranking of the largest health insurance companies by market share:

Centene $CNC (CNC), Blue Shield of California, Blue Cross Blue Shield (BCBS) of Michigan, and BCBS of Florida each hold 2% of the market.

Kaiser Permanente, which merged with Geisinger in 2023, has a market share of 7%

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

Cigna $CI, which bought Express Scripts and in 2023, holds 11% of the market.

CVS Health $CVS, the parent company of Aetna, controls 12% of the market.

Elevance Health (ELV), formerly known as Anthem $ELV, comes in second place in the ranking, holding 12% of the market.

UnitedHealth $UNH Group (UNH), the parent of United Healthcare, is the largest health insurance company in the U.S. with a market cap north of $500 billion. It serves more than 29 million Americans and controls 15% of the market.