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Distance-based pricing can help achieve equity objectives. Since annual vehicle mileage tends to increase with income, fixed-price insurance causes lower-income motorists to subsidize the insurance costs of higher-income motorists within their rate class. Distance-based insurance pricing provides overall savings to lower-income motorists, and would allow some low-income households to own a vehicle for basic mobility that they cannot currently afford. Distance-based pricing lets motorists save money by reducing mileage, an option that is currently unavailable. To illustrate this, consider the situation of somebody who becomes unemployed and so reduces driving by half. With current pricing, they continue paying the same insurance premiums as when they were employed and commuting,. | Premiums Soaring in Consolidated Health Insurance Market Lack of Competition Hurts Rural States Small Businesses MAY 2009 HEALTH CARE HI film I FOR AMERICA rauwi QUALITY AFFORDABLE HEALTH CARE WE ALL CAN COUNT ON. www.HealthCareforAmericaNow.org Acknowledgments Health Care for America Now would like to thank Alex Lawson Justin Berrier Thomas M. Hunt Deepika Mehta Doneg McDonough Diane Archer Julie Chinitz Monica Sanchez Margarida Jorge Dennis P. Osorio Toby Chaudhuri the Northwest Federation of Community Organizations and the Institute for America s Future. Note This report makes use of data published by the American Medical Association AMA which is not a member of the Health Care for America Now coalition. The AMA did not collaborate with HCAN on this report. 2 HEALTH CARE FOR AMERICA NOW Families Businesses Suffer as Insurers Pursue Local Monopolies Across U.S. HEALTH CARE COSTS have surged in recent years outpacing the growth in Americans income. Commercial health insurance premiums have risen four times faster than wages and have more than doubled in the last nine years.1 Shrinking competition among health insurance companies is a major cause of these spiraling costs. In the past 13 years more than 400 corporate mergers have involved health insurers and a small number of companies now dominate local markets. The American Medical Association reports that 94 percent of insurance markets in the United States are now highly concentrated. Contrary to industry assertions these mergers have undermined market efficiency premiums have skyrocketed increasing more than 87 percent on average over the past six years.2 3 Families and employers and the U.S. economy as a whole cannot sustain that kind of cost growth. The consequences of lax antitrust enforcement for consumers are clear then-Senator Barack Obama said in a September 2007 address to the American Antitrust Institute. The number of insurers has fallen by just under 20 percent since 2000. These changes were supposed
