The AMA aims to protect patients and physicians by actively opposing anticompetitive health insurer mergers.
At a June 19, 2018, hearing before the California Department of Insurance, in testimony presented by American Medical Association (AMA) President Barbara L. McAneny, MD, the AMA urged regulators to block the proposed CVS-Aetna merger. The AMA came to this position after conducting an exhaustive merger analysis. This stance is based on evidence indicating the merger’s likely anticompetitive effects on Medicare Part D, pharmacy benefit management services, health insurance, retail pharmacy, and specialty pharmacy.
Later this month, the AMA will file a post-hearing memorandum outlining its concerns. The filing will outline the merger’s potential negative consequences for health care access, quality and affordability, including:
- An expected increase in premiums due to a substantial increase in market concentration in 30 of 34 Medicare Part D regional markets.
- An anticipated increase in drug spending and out-of-pocket costs for patients as Aetna and CVS fortify their dominant positions in the health insurance, pharmaceutical benefit management, retail and specialty pharmacy markets that already lack competition.
- Reduced competition in health insurance markets that will adversely affect patients with higher premiums and contribute to a decline in the quality of insurance.
- A foreseeable failure to realize proposed efficiencies and benefits because the merger faces enormous implementation challenges, and those efficiencies have a questionable evidence base.
Because of this hearing called by California Insurance Commissioner David Jones, federal and state antitrust officials now have powerful reasons to block this harmful merger and foster a more competitive marketplace that will operate in patients' best interests. The AMA is working to persuade federal and state regulators to oppose the merger.