Health Insurance Mergers Mean...

Higher insurance premiums as the number of national insurers potentially go from five to three.

Less innovative methods of care since insurers will have less need to compete for consumers.

No assurance of coverage, benefit coordination, or other efficiencies and considerations that typically offset competitive harms.

Will Health Insurance Mergers Impact You?

THE FACTS

Today, there are only five national competitors -- UnitedHealth, Anthem, Cigna, Aetna and Humana. This makes health insurance markets already highly consolidated and insurance premiums are increasing because of it.  State Insurance Commissioners and Congress are investigating the Anthem/Cigna and Aetna/Humana mergers. The Department of Justice and many State Attorneys General  filed suit to block the mergers, on the grounds that they are anticompetitive and will harm consumers. To see the trial documents, click here

 

The CPPC believed these mergers should be challenged or patient choice would suffer. In fact, studies have shown previous health insurance mergers resulted in increases ranging from 7% (Dafny) to 13.7% (Guardado).  The argument that health insurers drive down health costs has no impact on consumers -- historically, no savings are passed along to consumers. Instead, insurance costs rise for employers, individuals, and families. 

The proposed mergers of Anthem and Cigna and Aetna and Humana were ruled anticompetitive in federal court. Thank you to everyone who opposed the mergers and fought to protect consumers and competition!

Fact Sheets
Studies & White Papers

Comment letter to DOJ from Consumers Union, Families USA, Consumer Action, Consumer Watchdog, Consumer Federation of America, and U.S. PIRG 7.7.16

Comment letter to DOJ from Medical, Consumer, and Advocacy Organizations 6.28.16

Comment letter to Georgia Office of Insurance and Safety Fire Commissioner from Consumer Action, US PIRG, Consumers Union, Consumer Federation of America, and Consumer Watchdog 6.28.16 

Comment letter to Missouri Department of Insurance, Financial Institutions, and Professional Registration from the Law Offices of David Balto 6.28.16 

Comment letter to New York Department of Financial Services from Consumer Action, Consumers Union, Health Care for All New York, 1199 United Healthcare Workers East, and Sergeants Benevolent Association 6.22.16

Comment letter to DOJ from Senator Richard Blumenthal (D-CT), Al Franken (D-MN), Elizabeth Warren (D-MA), Sherrod Brown (D-OH), Edward Markey (D-MA), Dianne Feinstein (D-CA), and Mazie Hirono (D-HI) 6.22.16

Comment letter to DOJ from California Insurance Commissioner Dave Jones 6.16.16 

Comment letter to Missouri Department of Insurance, Financial Institutions, and Professional Registration from Missouri State Medical Association 5.16.16 

 

Comment letter to Missouri Department of Insurance, Financial Institutions, and Professional Registration from Missouri Health Advocacy Alliance 5.16.16

 

Comment letter to Missouri Department of Insurance, Financial Institutions, and Professional Registration from Missouri Hospital Association 5.13.16

 

Comment letter to Virginia State Corporation Commission from Virginia Hospital & Healthcare Association 5.10.16

 

Comment letter to Missouri Department of Insurance, Financial Institutions, and Professional Registration from Empower Missouri, Missouri Budget Project, Missouri Health Advocacy Alliance, Missouri Health Care for All, US PIRG, Consumer Action, Consumers Union, Consumer Federation of America, and SEIU Healthcare Illinois, Indiana, Missouri, and Kansas 5.9.16

 

Comment letter to Florida Attorney General from Florida Campaign For Consumer Choice 5.5.16

 

Comment letter to U.S. Department of Health and Human Services from American Hospital Association 5.2.16

Comment letter to Indiana Department of Insurance from Indiana State Medical Association 4.29.16

 

Comment letter to Indiana Department of Insurance from Consumer Action, Consumers Union, Citizens Action Coalition, AFSCME, Consumer Federation of America, Consumer Watchdog, and US PIRG 4.25.16

 

Comment letter to California Department of Insurance from Consumers Union 4.25.16

 

Comment letter to DOJ from the American Hospital Association 4.18.16

 

Comment letter to Iowa Insurance Division from AFSCME, Consumer Action, Consumers Union, Consumer Watchdog, Consumer Federation of America, NAMI Iowa, SEIU Health IA, Iowa Citizens for Community Improvement, and League of Women Voters of Iowa 4.8.16

 

Comment letter to California Department of Insurance from California Medical Association 4.1.16

 

Comment letter to Wisconsin Office of the Commissioner of Insurance from State Representative Eric Genrich and State Senator Dave Hansen 3.28.16

 

Comment letter to California Department of Insurance from Consumer Watchdog 3.28.16

 

Comment letter to California Department of Insurance from Health Access California 3.25.16

 

Comment letter to Connecticut Insurance Department from Connecticut Campaign for Consumer Choice 3.22.16

 

Comment letter to Wisconsin Office of the Commissioner of Insurance from Consumer Action, Consumers Union, Citizen Action of Wisconsin, SEIU Healthcare Wisconsin, Consumer Federation of America, US PIRG, WISPIRG, Wisconsin Jobs Now, Coalition of Wisconsin Aging Groups, Wisconsin AFL-CIO, ABC for Health, Wisconsin Federation of Nurses and Health Professionals, American Federation of State, County, and Municipal Employees, National Association of Social Workers, Wisconsin Chapter, 9to5 Association of Working Women, Wisconsin, Wisconsin Farmers Union, and National Alliance on Mental Illness Wisconsin 3.21.16

 

Comment letter to California Department of Managed Health Care From California Medical Association 3.16.16

 

Comment letter to Connecticut Insurance Commissioner from Connecticut State Legislators 3.11.16

 

Comment letter to California Department of Managed Health Care from Health Access California 3.11.16

 

Comment letter to California Department of Managed Health Care From Consumer Watchdog 3.4.16

 

Comment letter to Georgia Office of Insurance and Safety Fire Commissioner from the Medical Association of Georgia 3.1.16

 

Comment letter to DOJ from the American Hospital Association 2.29.16

 

Comment letter to Wisconsin Office of the Commissioner of Insurance and State of Connecticut Insurance Department from American Hospital Association 2.23.16

 

Comment letter to Illinois Department of Insurance from Consumers Union, U.S. PIRG, SEIU Healthcare Illinois and Indiana, Illinois PIRG, Health & Medicine Policy Research Group, Consumer Federation of America, Consumer Watchdog, Citizen Action of Illinois, Consumer Action, Citizen Advocacy Center, and Sergeant Shriver National Center on Poverty Law 2.23.16

 

Comment letter to Ohio Department of Insurance from Consumers Union, Universal Health Care Action Network of Ohio, U.S. PIRG, Consumer Federation of America, Consumer Action, Consumer Watchdog, and DC 37 AFSCME 2.10.16

 

Comment letter to Illinois Attorney General from the Illinois Health and Hospital Association 2.8.16

 

Comment letter to Illinois Department of Insurance from the Illinois Health and Hospital Association 2.8.16

 

Comment letter to Kansas Attorney General from the Kansas Hospital Association 1.16.16

 

Comment letter to Kansas Insurance Department from the Kansas Hospital Association 1.15.16

 

Comment letter to California Department of Manged Health Care from Health Access California 1.11.16

 

Comment letter to California Department of Manged Health Care from Consumer Watchdog 1.11.16

 

Comment letter to California Department of Managed Health Care from Consumer Action 1.11.16

 

Comment letter to Virginia State Corporation Commission from Consumers Union, Virginia Consumer Voices for Healthcare, Virginia Organizing, Virginia Rural Health Association, Consumer Action, the Commonwealth Institute, U.S. PIRG, Consumer Watchdog, SEIU Virginia 512, and DC 37 AFSCME 1.11.16

 

Comment letter to DOJ from the American Antitrust Institute 1.11.16

 

Comment letter to Virginia State Corporation Commission from the Virginia Hospital & Healthcare Association 1.8.16

 

Comment letter to Florida Office of Insurance Regulation from Consumers Union, Florida CHAIN, Florida Rural Health Association, U.S. PIRG, Consumer Watchdog, Florida Policy Institute, Consumer Action, Florida PIRG, and 1199 SEIU United Healthcare Workers East 12.16.15

 

Comment letter to DOJ from the American College of Physicians 12.3.15

 

Comment letter to Missouri Attorney General from Missouri Association of Osteopathic Physicians and Surgeons, Missouri Hospital Association, and Missouri State Medical Association 11.10.15

 

Comment letter to Missouri Department of Insurance from Missouri Association of Osteopathic Physicians and Surgeons, Missouri Hospital Association, and Missouri State Medical Association 11.10.15

 

Comment letter to New Hampshire Governor from the New Hampshire Hospital Association 11.9.15

 

Comment letter to DOJ & FTC from Representatives Joseph Kennedy III, Paul Tonko, Doris Matsui & Jan Schakowsky 10.29.15

 

Comment letter to DOJ from the Texas Medical Association 10.6.15

 

Comment letter to DOJ from the American Psychiatric Association 9.9.15

 

Comment letter to DOJ & HHS from the American Hospital Association 9.1.15

 

Comment letter to DOJ from the American Academy of Family Physicians 8.28.15

 

Comment letter to DOJ from Healthcare Providers 8.13.15

 

Comment letter to DOJ from the American Hospital Association  8.5.15

 

 

 

 

Letters

"Public Hearing on the Proposed Merger on Anthem, Inc. and Cigna Corporation"

Virginia State Corporation Commission Hearing on Anthem-Cigna 5/25/16

TRANSCRIPT

"In the Matter Of: Acquisition of Control of: Cigna Healthcare of Indiana"

Indiana Department of Insurance Hearing on Anthem-Cigna 4/29/16

TRANSCRIPT

 

"Hearing to Elicit Testimony and Comments Regarding the Possible Implications of the Proposed Merger between Humana, Inc. and Aetna, Inc"

California Department of Insurance Hearing on Aetna-Humana 4/27/16

TRANSCRIPT

EXPERT TESTIMONY

VIDEO

 

"Hearing to Elicit Testimony and Comments Regarding the Possible Implications of the Proposed Merger between Anthem, Inc. and Cigna Corporation"

California Department of Insurance Hearing on Anthem-Cigna 3/29/16

TRANSCRIPT

EXPERT TESTIMONY

VIDEO

 

"Healthy Competition? An Examination of the Proposed Health Insurance Mergers and the Consequent Impact on Competition"

House Judiciary Subcommittee Hearing 9/25/15

WITNESS LIST & TESTIMONY

VIDEO

 

"Examining Consolidation in the Health Insurance Industry and its Impact on Consumers"

Senate Judiciary Subcommittee Hearing 9/22/15

WITNESS LIST & TESTIMONY

VIDEO

 

"The State of Competition in the Health Care Marketplace"

House Judiciary Subcommittee Hearing 9/10/15

WITNESS LIST & TESTIMONY

VIDEO

 

Congressional & 
State Hearings
Past Enforcement Actions

United States v. Aetna (1999) Summary: Merger of Aetna and Prudential, two of the largest insurance companies in 1999.  The competitive concerns were in overlaps between the parties' HMO and POS plans.  While the most significant overlaps were found in Texas, the DOJ was also  concerned about the combined "purchasing power" of the parties to "depress physicians' reimbursement rates."  The merger was allowed, but the DOJ required the parties to divest HMO plans in Houston and Dallas. 

 

United States v. UnitedHealth (2005) Summary: Merger between dominant insurers UnitedHealth and PacifiCare.  Both insurers sold HMOs and PPOs in a number of different states.  The DOJ's investigation focused on mainly Arizona and Colorado.  Merger was consummated, but the parties were forced to divest all commercial health insurance in Tucson, AZ and Boulder, CO.  United was also forced to terminate its "network access agreement with Blue Shield of California."

 

United States v. UnitedHealth (2008) Summary: Merger between UnitedHealth and Sierra Health.  Sierra's main focus was Medicare Advantage plans, but was also the largest insurer in the State of Nevada.  The combined United and Sierra would have had a 94% market share for Medicare Advantage enrollees in Las Vegas.  DOJ forced the parties to only divest Sierra's Medicare Advantage portfolio.

 

Independence Blue Cross and Highmark's failed merger (2009) Summary: The merger of Independence and Highmark would have created an entity with 73% market share in Pennsylvania. The Pennsylvania Insurance Department opposed the merger, and in 2009 the parties dropped their plans to merge.

 

Blue Cross Blue Shield of Michigan and Physicians Health Plan of Mid-Michigan failed merger (2010) Summary: Blue Cross had a 70% market share while PHP had a 20% market share and controlled the largest hospital system in the state of Michigan.  After the DOJ threatened to file suit to prevent the merger, the parties abandoned the transaction.

 

United States v. Humana (2012) Summary: Merger between Humana and Arcadian Management Services.  Both parties primary business is through Medicare Advantage plans.  The DOJ concluded that there were significant overlaps in five different states-- Arizona, Arkansas Louisiana, Oklahoma, and Texas.  The parties were allowed to merge, but they were required to divest Arcadian's Medicare Advantage plans in 51 counties throughout the five states.

 

United States v. WellPoint (2012) Summary: Merger between WellPoint, acquired by Anthem in 2004, and Amerigroup. Amerigroup specialized in Medicaid Managed Care products.  The DOJ allowed the parties to consummate the merger, but required Amerigroup to sell its Medicaid Managed Care plans in Northern Virginia.