Executive Summary
The United States health insurance market is the largest in the world. Despite the fact that 8% of Americans lack health insurance, the US continues to see the highest rate of increase in health premiums in North America. There are two types of health insurance in the United States, private and public. Most people use a combination of both.
The health insurance industry in the United States has experienced phenomenal growth as a result of rising employer-sponsored insurance demand and rising average premium costs. Additionally, increased internet use and digitization have a favorable impact on the whole US health insurance market.
One of the significant drivers of the US health insurance industry is the increasing aging population. The country is aging. Approximately one in five Americans will be 65 years of age or older by 2040, up from one in eight in 2000. Over the next 40 years, the number of Americans 65 and older will more than double, reaching 80 million in 2040.
Impact of COVID-19 Pandemic on National Health Spending in 2020
The US health care spending increased significantly in response to the pandemic, primarily as a result of increased federal spending, which included funding for the Provider Relief Fund (USD 122 billion in 2020) and the Paycheck Protection Programme (USD 53 billion in 2020) to help providers make up for lost income. In 2020, the COVID-19 pandemic had a significant influence on the country's healthcare system, resulting in a 9.7% increase in overall national healthcare costs, pushing total expenditures to USD 4.1 trillion.
Amendments in the Policies
Amendments made by the US government in the policies during the pandemic for helping the population get and stay covered under health insurance have helped in reducing the number of people uninsured and reaching its all-time low.
The latest decision to expand Medicaid eligibility under the Affordable Care Act (ACA) by several states has also helped in reducing the number.
Performance of Segmentation
By Type of Insurance Provider: The United States Health Insurance Plans by Type of Insurance Provider is divided into private individual plans and employer-based health insurance plans. The largest share was held by private individual plans in 2022. These plans are typically purchased directly by individuals and families from private health insurance companies or through health insurance marketplaces/exchanges.
Direct Written Premium by Line of Business: The US health insurance market’s direct written premium by line of the business segment is divided into comprehensive, Medicare Supplement, FEHBP, Medicaid, Medicare, and others. Medicare and Medicaid account for the major market share. The top three highest increases in gross written premiums from 2020 were Medicare, Medicaid, and Individual Comprehensive in 2021. An increase in enrolment and premium rates can be linked to the growth of Medicaid and Medicare.
Future Outlook
Due to the pandemic and the economic slowdown brought on by the Russia-Ukraine conflict, the majority of insurance carriers in the United States of America have shown great flexibility and resilience in overcoming a variety of obstacles during the past few years. A lot of work was put into enhancing the systems and capacities, and it clearly paid off to have nimble talent and technological tactics.
Overall, the future of health insurance is expected to be distinguished by a trend towards consumer-driven healthcare, the use of technology to improve the healthcare experience, and a greater emphasis on mental health and behavioral health. By 2026, the market is expected to reach at a saturation point and witness positive growth but at a slow pace.
Scope of the Study
Makreo Research has published a study on Insurance Market specific to Health Insurance titled, “The United States Health Insurance Market”. The study evaluates the health assessment profile with a detailed assessment of different sectors of the United States. The market has witnessed many shifts in the recent past that have impacted the profit margins of the players but also accounted for a rise in demand of private health insurance thus this report highlights the private and public health insurance market. The report is the right blend of qualitative and quantitative factors with market dynamics and sector assessment.
Segmentation Covered
By Type of Insurance Provider: Private individual plans and Employer-based health insurance plans.
Direct Written Premium by Line of Business: Comprehensive, Medicare Supplement, FEHBP, Medicaid, Medicare and others.
Companies Covered: United Health, Elegance Health, Centene Corp, CVS Health Corporation, Humana Inc, The Cigna Group, Molina Healthcare, Health Care Service Corporation.
Health Assessment Profile: Life Expectancy Rate, Chronic Disease, Mortality Rate, Opioid Epidemic, Mental Health Issue, Health Insurance Coverage.
Key Questions Answered
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Table of Content
Report Synopsis
1. Research Methodology
1.1. Objective of the Study
1.2. Research Process
1.3. Data Collection Methods
1.4. Analytical Framework
2. United States – Economy Assessment
2.1. United States Health Insurance – Economic, Political and Demographic Factors
2.1.1 Economic, Political and Demographic Factors – Economy Overview
2.1.2. Economic, Political and Demographic Factors – Political Overview
2.1.3. Economic, Political and Demographic Factors – Demographic Overview
3. United States Health Assessment Profile
3.1. United States Health Assessment Profile: Life Expectancy Rate
3.2. United States Health Assessment Profile: Chronic Disease
3.3. United States Health Assessment Profile: Mortality Rate
3.4. United States Health Assessment Profile: Opioid Epidemic
3.5. United States Health Assessment Profile: Mental Health Issue
3.6. United States Health Assessment Profile: Health Insurance Coverage
4. United States Health Insurance – Past and Present Analysis
4.1. United States Health Insurance Market: An Overview
4.1.1. United States Health Insurance Market Snapshot
4.2. United States Health Insurance Market: Pre-Pandemic Scenario
4.2.1. Percentage of People without Health Insurance Coverage by States in United States
4.2.2. Population by Type of Health Insurance Coverage by Race and Hispanic Origin
4.2.3. Type of Health Insurance Coverage by Income and Poverty
4.2.4. Type of Health Insurance Coverage by Marital Status
4.2.5. Type of Health Insurance Coverage by Category of Working Population
4.3. National Health Spending: 2020
4.4. Impact of COVID-19 over United States Health Insurance Market: 2020
4.4.1. United States Health Insurance Market by Health Insurance Coverage: 2020
4.5. United States Health Insurance Market: Post Pandemic Scenario
4.5.1. United States Health Insurance Market by Health Insurance Coverage
4.5.2. United States Health Insurance Market by Uninsured Coverage
4.6. United States Health Insurance Market Revenue: Past & Present Assessment
4.6.1. United States Health Insurance Market: Direct Written Premium
5. United States Health Insurance Market by Segmentation
5.1. United States Health Insurance Market: Individual vs. Employer Based
5.2. United States Health Insurance Market: Direct Written Premium by Line of Business
5.3. United States Health Insurance Market: Net Earned Premium
5.3.1. United States Health Insurance Market: Net Earned Premium (Medicare vs Medicaid)
5.4. United States Health Insurance Market: Enrolment
6. United States Health Insurance Market – Market Dynamics
6.1. Recent Trends & Development
6.2. Market Driving Factors
6.3. Market Challenges
7. United States Health Insurance – Funding Timeline
7.1. United States Health Insurance – Funding Timeline
8. United States Health Insurance Market – Future Outlook
8.1. United States Health Insurance Market: Future Outlook
8.2. United States Health Insurance Market Revenue: Future Outlook
8.3. Factors to Drive Future Growth of the United States Health Insurance Market
List of Figures and Tables
The United States Real GDP growth (annual % Change), 2018-2023
The United States Share of Insurance Sector in Gross Domestic Product (GDP), 2017-2021
The United States Annual Unadjusted Inflation Rate, 2022-23
The United States FDI, Net inflows (% of GDP), 2018-2021
Political Framework Parameters of Developed Economies
Political Framework Parameters of Emerging Economies
The United States Population, 2018-2021
The United States Population ages 65 and above (% of the total population), 2018-2021
The United States Expected Life Expectancy, 2018-2021
No of States with Adult Obesity Rate above 30%, 2017-2021
The United States Infant Mortality Rate, 2017-2021
The United States Maternal Mortality (In Number), 2019-2022
Number of Deaths Due to Opioid Overdose, 2019-2022
Percentage of People Who Took Treatment for Mental Illness, 2019-2021
Percentage of Subtype of Health Insurance Coverage
Underwritten Gain/Loss, 2018-2021
Number of Companies Filed, 2018-2021
Number and Percentage of People by Health Insurance Coverage Status and Type, 2018-2019
Percentage of People without Health Insurance Coverage by States in United States (2010, 2018 & 2019)
Number and Percentage of People by Race and Hispanic Origin of Health Insurance Coverage, 2018-2019
Number and Percentage of People by Income to Poverty Ratio of Health Insurance Coverage, 2018-2019
Percentage of People by Marital Status Type of Health Insurance Coverage, 2018-2019
Percentage of People by Work Experience Type of Health Insurance Coverage, 2018-2019
Number and Percentage of People by Health Insurance Coverage Status and Type, 2020
Percentage of People by Type of Health Insurance Coverage, as of March 2020
Number and Percentage of People by Health Insurance Coverage Status and Type, 2021
Percentage of People Uninsured by Age Group: 2020 and 2021 (%)
Percentage of People Who Were Uninsured or Had Public or Private Coverage, By Age Group: United States, January–June 2022 (%)
The United States Health Insurance Market Revenue, 2018-2022
The United States Health Insurance Direct Written Premium, 2018-2021
The United States Health Insurance Direct Written Premium, H1 2018 - H1 2022
Market Share of United States Health Insurance Plans by Type of Insurance Provider, 2022 (%)
Individual Health Insurance Market Revenue, 2017-2021
Employer Health Insurance Market Revenue, 2017-2021
Market Share of the United States Health Insurance Direct Written Premium by Line of Business, 2021 (%)
Market Value the United States Health Insurance Direct Written Premium by Line of Business, 2018 - 2021
The United States Health Insurance Net Earned Premium, 2018-2021
The United States Health Insurance Net Earned Premium, H1 2018 – H1 2022
The United States Health Insurance Net Earned Premium of Medicare, 2018-2021
The United States Health Insurance Net Earned Premium of Medicaid, 2018 –2021
The United States Health Insurance Enrollment, 2018-2021
The United States Health Insurance Enrollment, H1 2018 – H1 2022
Marketplace Enrolment Snapshot