Congress Questioning Healthcare Companies
Which of your companies own or control a health insurance division? If you also employ healthcare providers or own clinics, specialty pharmacies, or any other kind of medical practice or pharmacy, please keep your hand up. If you also own or control a pharmacy benefit manager, and please keep your hand up. If you lead publicly traded companies at which you have a legal responsibility to maximize shareholder value.
So we’ve established on the record that the largest health insurance companies are not just insurers. They’re also medical providers and pharmacy companies diagnosing and deciding treatment for patients. They’re also PBMs, another form of middlemen managing drug benefits. They’re increasingly controlling every aspect of our healthcare system.
Largest Health Insurance Companies
UnitedHealth Group stands as the leading health insurance provider in the U.S., both in terms of revenue and market share, capturing about 16% of the market and recording over $269 billion in direct written premiums in 2024. In contrast, Kaiser Permanente is recognized for having the largest enrollment, boasting over 8.5 million members, despite its operations being limited to eight states and Washington, D.C.
The top five health insurance companies by revenue, which collectively account for nearly half of the U.S. health insurance market, are:
- UnitedHealth Group ($269.4B in premiums, 16.05% market share) Owns Optum Rx pharmacy
- CVS Health (including Aetna health insurance) ($121.2B in premiums, 7.22% market share) Owns CVS Pharmacy
- Centene Corporation (including Ambetter health insurance) ($113.1B in premiums, 6.74% market share) SOLD its pharmacy benefit management business to Magellan Rx Pharmacy and PANTHERx Rare Pharmacy, in May 2022 for a total of $2.8 billion.
- Humana Inc. ($110.5B in premiums, 6.59% market share) Owns CenterWell Pharmacy and CenterWell Specialty Pharmacy brands
- Elevance Health Inc. (formerly Anthem health insurance) ($108.1B in premiums, 6.44% market share) Owns CarelonRx Pharmacy
