Update: Health Insurance Mergers

The North Carolina Medical Society (NCMS) along with our national partners, The Physicians Foundation, PAI and the American Medical Association (AMA) are closely monitoring and speaking out on the proposed mergers between health insurance giants Aetna and Humana and Anthem and Cigna. The mergers currently are under review by the US Department of Justice’s anti-trust division.

In light of a variety of studies, including a comprehensive review of the issues surrounding the merger by the AMA [read the AMA’s study], organized medicine has serious concerns over these mergers and the resulting concentration of market share in the health insurance industry.

Recent comments by the DOJ’s top anti-trust enforcer, Assistant Attorney General Bill Baer shed some light on the concerns the DOJ has with the proposed mergers as well. Baer was speaking at a Yale Law School Conference on competition in the health care industry and was quoted as saying: “Consumers do not benefit when sellers – or buyers – merge simply to gain bargaining leverage. Consumers benefit when there is entry, expansion, innovation and competition.”

He also expressed concern about the possible impact on Affordable Care Act health insurance exchanges.

“Consumers who use exchanges with more competition enjoy lower premiums then those who have fewer choices,” he said.

The AMA recently sent a 17-page letter to Baer with an analyses of the proposed health insurance mergers and the impact they would have on consumers in terms of health care access, quality, and affordability. Read the letter.

The AMA urged DOJ to block the mergers, concluding 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).

Read more about the AMA’s work on this issue.

Watch the NCMS Bulletin for updates.

 
 

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