Aetna-Humana and Anthem-Cigna were two big proposed transactions that were going to further limit the choices you and your patients would have for health insurance in this market. Besides United Healthcare and Blue Cross, all my clients have substantial business with Humana and Cigna, the two companies to be absorbed by their proposed partners.

After a year of review, the US government is close to formally challenging these transactions. In other words, THESE MERGERS ARE IN TROUBLE BECAUSE THE GOVERNMENT IS WORRIED THE DEALS WILL REDUCE COMPETITION, HAVE A BIG IMPACT ON INDIVIDUAL INSURANCE PLANS, AND GIVE THE REMAINING FEW PAYORS GREATER LEVERAGE IN REIMBURSEMENT NEGOTIATIONS. That last point should really get your attention.

So if indeed the government goes forward to contest these transactions , they’ll need to convince a judge to block the deals. What may happen is that the two acquirers – Aetna and Anthem – may have to sell off business to other health insurers where they overlap with the companies they are acquiring.

I bring this to your attention to convey that nothing is going to change until this is resolved, and that Humana and Cigna will continue to be major players in this market.

A.J. Rosmarin
July 2016