Ark Blue Dogs' congressional district dominated by one of biggest health insurance monopolies in country

Yesterday, Rep. Mike Ross (D-Ark) -- leader of the conservative Blue Dog's health reform efforts -- made the not-so-surprising announcement that he would oppose a health reform bill if it included a public option, a government-backed insurance choice.Rep. Ross said the reason for his opposition is because "an overwhelming number" of his constituents don't want it. He also said it was critical the bill serve "those of you who like your current health insurance plan."

But most of Rep. Ross' constituents have little way to compare how their health plan sizes up, because one company -- Blue Cross Blue Shield of Arkansas -- holds a monopoly on the local health insurance market.

In Arkansas, Blue Cross controls 75 percent of the state's health insurance market in HMO and PPO plans, according to an American Medical Association report in 2007 [pdf] (the latest figures available).

That means the state ranks 5th-highest in the nation for the share of the market dominated by one company (tied with Montana).

And in a state with little health insurance competition, Rep. Ross' district is among the worst. Arkansas' 4th Congressional district includes Texarkana, which ranked as the city with the least health insurance competition in the country out of 313 metro areas analyzed in the AMA study.

Fully 97 percent of the health insurance market in Texarkana -- which shares a border with Arkansas and Texas -- has been cornered by Blue Cross Blue Shield AR.

The U.S. Justice Department considers a market "highly concentrated" ifone company holds more than a 42 percent share of that market.