The American Medical Association has cited new data to oppose the mergers of Anthem and Cigna, and of Aetna and Humana, on antitrust grounds.
Data from the 2016 edition of the AMA's "Competition in Health Insurance: A Comprehensive Study of U.S. Markets," which the organization says "offers the largest and most complete picture of competition in health insurance markets for 388 metropolitan areas, as well as all 50 states and the District of Columbia," was used to support the AMA's position that "[l]eft unopposed, Anthem's acquisition of Cigna and Aetna's takeover of Humana would collectively quash competition in insurance markets across 24 states … ."
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According to the study, not only should the mergers be viewed as reducing five national health insurance carriers to three, but also in the context of "the unprecedented lack of competition that already exists in most health insurance markets." The AMA said that in 71 percent of the metropolitan areas studied, there is a "significant absence" of competition and the markets are rated "highly concentrated."
In addition, in 40 percent of the markets in the study, one health insurer held at least a 50 percent share of the commercial health insurance market. And 14 states had a single health insurer that had at least a 50 percent share of the market: Alabama, Delaware, Hawaii, Illinois, Indiana, Louisiana, Michigan, Nebraska, North Carolina, North Dakota, Rhode Island, South Carolina, Vermont and Wyoming.
The AMA said that the Aetna-Humana merger would cut competition in 51 metropolitan areas located in 15 states, including Arizona, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Ohio, Tennessee, Texas, Utah, Wisconsin and West Virginia. It pointed out that four of the 15 states are working to block the merger, while the others have not yet taken an antitrust position on the transaction.
Concerning the Anthem-Cigna merger, the AMA said it would cut competition in 121 metropolitan areas located throughout the 14 states where Anthem provides commercial coverage, including California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. Nine of these states, it added, are working to stop the merger; the other four have not yet taken an antitrust position.
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