Four corporations now control nearly 70 percent of the American grocery market. Five insurance conglomerates cover roughly half the country's health plans. Four airlines carry 80 percent of domestic passengers. None of this happened by accident, and in 2025, the agency charged with preventing it cleared $2.3 trillion in U.S. mergers without blocking a single transaction.
How Concentrated Markets Become Toll Booths
Concentration does not start out as a scandal. It starts as efficiency. A retailer acquires a regional chain to lower logistics costs. An insurer buys a pharmacy benefit manager to streamline claims. A hospital system absorbs a competitor to improve care coordination. Then the savings go to shareholders, prices rise anyway, and consumers discover they have nowhere else to go.
The grocery sector is the clearest example. Between 2000 and 2023, the top-four grocery retailers' share of the national market climbed from 42.5 percent to 67 percent, according to Farm Action's analysis of grocery retail concentration. Walmart, Kroger, Costco, and Albertsons now form something close to a private utility for food in much of the country. In 2023, when overall food inflation was easing, Kroger's senior director for pricing acknowledged in testimony during the chain's antitrust trial that it had raised prices for staples like eggs and milk beyond what its own cost increases warranted. The Federal Trade Commission, in its 2024 grocery report, found that some firms used rising costs as an opportunity to expand their margins further. That is not a side effect of inflation. That is the exercise of market power.
Health insurance tells a similar story. The five largest insurers (UnitedHealth Group, Kaiser, Elevance, Centene, and HCSC) together cover roughly half the U.S. market, according to the Peterson-KFF Health System Tracker. UnitedHealth alone enrolled nearly 45 million Americans in 2025. In Medicare Advantage, the concentration is sharper: two companies account for nearly half of all enrollees. When the sector is this concentrated and denies a claim, you appeal to a panel run by the same insurer. When premiums rise, you choose between two or three plans that may all be underwritten by the same parent company.
"When a handful of companies dominate across inputs, processing, distribution, and retail, they can raise prices at will because consumers have nowhere else to go." (Farm Action, Grocery Retail: The Last Link in the Monopoly Chain)
The Merger Wave Nobody Stopped
Corporate profits have followed concentration upward. Total U.S. after-tax corporate profits reached $4.0 trillion at the end of 2024, representing 16.2 percent of national income, according to the Bureau of Economic Analysis. For comparison, the St. Louis Federal Reserve notes that corporate profits averaged 5 to 7 percent of GDP from the end of World War II through roughly 2000. They now sit closer to 11 percent. Over the same decades, wages as a share of GDP fell from approximately 58.5 percent in 1970 to 51.7 percent today. The productivity gains went somewhere. They went up, not out.
The Trump administration's response has been to open the door wider. In March 2025, the president fired the FTC's two Democratic commissioners, reshaping the agency to a bare Republican majority. Since then, the Department of Justice Antitrust Division has not blocked a single merger. The FTC challenged only a handful of deals, all valued under $1 billion, while U.S. companies completed $2.3 trillion in acquisitions during 2025 alone, part of a global M&A surge that topped $4 trillion. Among the deals that sailed through: a media consolidation where the acquiring party hired MAGA-affiliated lobbyists and made payments to political allies before receiving approval.
The argument from deregulation advocates is that size enables American companies to compete with state-backed foreign rivals, particularly in AI and energy. That argument deserves to be taken seriously. Government-backed industrial policy in China and elsewhere is real. The problem is that this rationale has been extended far beyond strategic industries to justify grocery chains absorbing regional competitors, insurers buying pharmacy benefit managers, and airlines code-sharing on routes where they used to compete. The consumer paying more for eggs in Appalachian Ohio is not winning a geopolitical chess match.
What Regulated Markets Actually Look Like
The standard response from monopoly critics (nationalize the grocery chains, put insurance under a single-payer government umbrella) carries its own risks worth naming. Centrally administered supply chains have failed repeatedly when they cannot respond to local signals. The Soviet grocery system did not collapse because the government lacked good intentions. It collapsed because no central planner could process the distributed information that prices carry in a functioning market. The lesson is not that markets are self-correcting. It is that the alternative to regulated private competition is not a painless public solution.
The case for strong antitrust enforcement is not ideologically socialist. It is classically pro-market. Antitrust law exists to preserve competition, not to replace it. The Sherman Act of 1890 was written by Republicans who believed concentrated private power was as dangerous to a free republic as concentrated government power. The tools are already in the statute books: block mergers that reduce competitors below a functioning threshold, require structural remedies (divestitures, not just consent decrees), and fund the agencies that enforce those rules at a level commensurate with the size of the companies they oversee. The FTC's entire annual budget is roughly $430 million. UnitedHealth Group's net income in 2024 was approximately $22 billion.
A regulated market with four meaningful grocery competitors in every metro area is not socialism. A market where four corporations divide the national food supply among themselves and raise prices during a cost-of-living crisis is not capitalism. It is a cartel that got there legally, one merger at a time.
Sources
- Farm Action: Grocery Retail: The Last Link in the Monopoly Chain
- The Hill: FTC Calls Out Profits as a Driver of Grocery Prices
- Bureau of Economic Analysis: GDP Third Estimate, Corporate Profits, 4th Quarter and Year 2025
- St. Louis Federal Reserve: What's Driving the Surge in U.S. Corporate Profits?
- FRED / St. Louis Fed: Corporate Profits After Tax as Share of Gross Domestic Income
- Peterson-KFF Health System Tracker: Recent Trends in Commercial Health Insurance Market Concentration
- U.S. Senate Judiciary Committee: Hearing on the Impact of Consolidation and Monopoly Power on American Innovation
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