Major players react to Aetna-Humana, Anthem-Cigna lawsuits

The antitrust lawsuits against Aetna’s acquisition of Humana and Anthem’s takeover of Cigna drew support from the American Medical Association (AMA) and American Hospital Association (AHA), while the largest health insurer trade group argued the deals would be beneficial to consumers.

The Department of Justice (DOJ) filed the lawsuits July 21, with U.S. Attorney General Loretta Lynch arguing the consolidation of four of the five largest health insurers would “drastically constrict competition” in major markets.

AMA President Andrew Gurman, MD, said in a statement the DOJ is right to block the “creation of two health insurer goliaths.”

“Allowing commercial health insurers to become too big and exert control over the delivery of health care would be bad for patients and vitality of the nation's health care system,” Gurman said. "With existing competition in health insurance markets already at alarmingly low levels, federal officials have a strong obligation to enforce antitrust laws that prohibit harmful mergers and foster a more competitive market place that will operate in the patients' best interests."

AHA President and CEO Rick Pollack made similar arguments in a blog post, calling the lawsuits “a victory for health care.”

“The proposed deals would have reduced the number of commercial health insurance giants from five to three—just three companies covering nearly 44% of insured Americans, with nearly $345 billion in revenue,” Pollack said. “That might be good for the bottom lines of these companies—but not for consumers, who would have faced fewer choices for coverage at higher costs.”

America’s Health Insurance Plans defended the deals, calling the lawsuits as a “step in an ongoing process,” and arguing the more pressing concerns on shrinking competition in the healthcare industry should be directed towards mergers of health systems and rising drug prices.

“Mergers among health plans can deliver significant benefits by combining complimentary areas of expertise to ensure consumers get the best value for their health-care dollars," said AHIP spokesperson Clare Krusing. "Notably, many insurance departments across the country have approved these mergers."

Eighteen state regulators approved the Aetna-Humana deal, and 10 signed off on the Anthem-Cigna merger. That support isn’t universal across all officials in those states, however—in Illinois, for example, the state’s insurance commissioner, Anne Melissa Dowling, granted approval for Aetna’s $37 billion acquisition of Humana, but Illinois Attorney General Lisa Madigan was a part of the DOJ’s antitrust lawsuit, arguing the deal would adversely affect 1.5 million Medicare Advantage customers in the state.

“This proposed merger would substantially lessen competition for Medicare Advantage patients across the country, including tens of thousands of patients in Illinois,” Madigan said. “With fewer options, costs for Illinois residents will inevitably increase.”

Both Aetna and Anthem have pledged to contest the lawsuits.