“The MLR has backfired completely,” he explained. “I’ve been predicting this from the beginning. This MLR thing will run the small companies out of the market. All this has done is to consolidate the market.”

If that’s the case, the media has a job to do keeping track of the insurance behemoths’ growing market power, and what that means for their audiences. And while they’re at it, they may want to investigate their local hospitals. Consolidation mania has caught up with them, too.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.