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AMA flags actions on pending unsurer mergers

November 16, 2015

The American Medical Association (AMA) has released a summary of the steps that it has taken to address the pending Anthem-Cigna and Aetna-Humana mergers.

AMA reports that, "On September 8, 2015, [it] released the 2015 edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets, which offers the largest and most complete picture of competition in health insurance markets for 388 metropolitan areas (MSAs), as well as all 50 states and the District of Columbia...study is based on 2013 data captured from commercial enrollment in HMOs, PPOs and POS plans."

AMA notes that a special analysis revealed that the "Anthem-Cigna merger would diminish competition in up to 111 metropolitan areas within all 14 states that Anthem currently operates and the Aetna-Humana merger would diminish competition in up to 58 metropolitan areas within 14 states."

AMA is stressing that, "The prospect of reducing five national health insurance carriers to just three should be viewed in the context of the unprecedented lack of competition that already exists in most health insurance markets...AMA continues to urge federal and state regulators to carefully review the proposed mergers and use enforcement tools to preserve competition."

AMA says is "testified twice in September before the House Judiciary Committee to express [its] concerns regarding the proposed Anthem-Cigna and Aetna-Humana mergers and met with key staff from both the U.S. Senate and the House of Representatives to discuss the anticompetitive effects that the proposed mergers would likely have on the nation's physicians."

AMA also notes that it is "engaging the National Association of Attorneys General and will be presenting to a majority of state Attorneys General in late November on the AMA Competition Study and our position as it relates to the proposed mergers."

Finally, AMA sent a letter to the U.S. Department of Justice (DOJ) to urge it to "block the mergers, concluding that the mergers will likely result in higher premiums for patients, a reduction in the quality of health insurance (e.g., less availability of providers, lower consumer service), and lower payment rates for physicians that lead to lower quality or quantity of the services that physicians are able to offer patients (e.g., less investment in newer technology)."

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