CVS Health has closed its $69 billion acquisition of health insurer Aetna after the deal was approved by all necessary regulators, but the transaction has hit a snag after a judge requested more information from the Department of Justice.

In the midst of a major consolidation period in the healthcare industry, a new report from the Trump administration sheds light on the current state of competition in the space.

While the $69 billion merger between CVS Health and Aetna has been approved by regulators and cleared by the Department of Justice, a federal judge has raised the prospect of not approving the deal, CNBC reported.

States will have more flexibility to introduce new healthcare options to residents under a new policy from CMS that impacts waivers.

The healthcare industry is in a period of rapid consolidation, with major mergers and acquisitions happening year to year. This consolidation is leading to high concentration levels in 73 percent of health insurance markets, according to a recent study from the American Medical Association.

The ongoing merger between CVS Health and Aetna officially closed Nov. 28, the companies announced. The $69 billion deal brings together one of the nation’s largest health insurers and retail pharmacy chains and pharmacy benefit managers.

The completion of the $67 billion merger between health insurer Cigna and Express Scripts has been delayed, according to a public filing. The deal was anticipated to close by December 8, but the companies have decided to delay that deadline by six months.

In another sign that the cost of healthcare is too high, one hospital system based in Grand Rapids, Michigan, denied a heart transplant to a woman and recommended she try to raise $10,000.