Competition in the health insurance industry is disappearing with more markets across the country dominated by one or two insurers, according to the American Medical Association’s newly released edition of “Competition in Health Insurance: A Comprehensive Study of U.S. Markets.”

In 24 of the 43 states reported in the new AMA study, the two largest insurers had a combined market share of 70% or more. Last year, just 18 of 42 states had two insurers with a combined market share of 70% or more.

“The near total collapse of competitive and dynamic health insurance markets has not helped patients,” said AMA president J. James Rohack, MD. “As demonstrated by proposed rate hikes in California and other states, health insurers have not shown greater efficiency and lower health care costs. Instead, patient premiums, deductibles and co-payments have soared without an increase in benefits in these increasingly consolidated markets.”