Too few Medicare Advantage insurers participate in 97 percent of U.S. counties, Commonwealth Fund reports, and the report states that the lack of competition in local markets among private plans does not bode well for Medicare proposals that rely on competition to improve the efficiency and quality of the Medicare program. The report also finds that even among the 100 counties with the greatest number of Medicare beneficiaries, 81 lacked significant competition. “Allowing private health insurers to play a larger...