Dive Brief:
- As Anthem seeks to acquire Cigna, and Aetna seeks to acquire Humana in two historic insurance industry megamergers, healthcare stakeholders have been waiting for indications of whether the U.S. Department of Justice will allow them or conclude they violate antitrust laws.
- While the attention has been on federal officials, the fate of the mergers may ultimately rest in the hands of state insurance regulators, Modern Healthcare notes.
- If key states reject the mergers, it may not be worthwhile for the mergers to proceed only within the states that accept it.
Dive Insight:
Even if the deals obtain federal approval, that won't serve as an indication as to how states will go because they are considering different criteria.
While the DOJ is focused on how the mergers would impact competition, state insurance commissioners also have to consider potential negative impacts to policy holders and the public, which gives them more latitude to reject the deals or make them conditional upon certain terms, such as controlled rate increases.
In addition, state insurance commissioners are required to hold public hearings to provide transparency. Most of the affected states are expected to hold their public hearings in the coming months, while a few -- Michigan, Utah and Vermont -- have already done so for the Aetna/Humana deal and approved it.
While politics and states' previous merger decisions may play factors in these decisions, they largely remain anyone's guess.
“There is no precedent among insurance commissioners for deals that are this big, that affect this many states,” New Jersey deputy insurance commissioner Jay Angoff told Modern Healthcare.