- A new analysis from the American Medical Association states the proposed mergers of Anthem-Cigna and Aetna-Humana would drive down competition in up to 154 metropolitan areas within 23 states.
- According to a prepared AMA statement, the combined impact of the proposed mergers would exceed federal antitrust guidelines in as many as 97 metro areas in 17 states.
- In nearly two out of five metropolitan areas studied, a single health insurer had at least a 50% share of the commercial health insurance market, according to the report.
This July, Frank Ingari, CEO of NaviNet, told Healthcare Dive that “In healthcare, it’s really important to consider local share because healthcare is an intensely local business.” Ingari stated he expects very substantial regulatory reviews that look at local share and the implications market by market.
"A lack of competition in health insurer markets is not in the best interests of patients or physicians," said AMA President Steven J. Stack, in a prepared statement. "If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums, and physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care.”
“Given these factors, AMA is urging federal and state regulators to carefully review the proposed mergers and use enforcement tools to preserve competition,” Stack concluded.
On an individual basis, the Anthem-Cigna merger would enhance market power in 85 metropolitan areas within 13 states, according to AMA analysis. In addition, the AMA states the Aetna-Humana merger would enhance market power in 15 metropolitan areas within 7 states.
The Aetna-Humana merger would also raise significant competitive concerns in additional markets, according to AMA. All told, the Aetna-Humana merger would diminish competition in up to 58 metropolitan areas within 14 states.
Federal regulators still must approve the Anthem-Cigna and Aetna-Humana acquisition plans.