Efforts to Block Mergers
In 2015, 4 of the 5 largest health insurers in the U.S. announced their intention to merge. The AMA used its 2016 update to Competition in Health Insurance to conduct analyses of the competitive impacts of the proposed Anthem-Cigna and Aetna-Humana mergers on commercial markets and the Aetna-Humana merger on Medicare Advantage markets. Those analyses found that both mergers would likely be anticompetitive in numerous markets across the U.S.
On Nov. 11, 2015, the AMA urged the U.S. Department of Justice (DOJ) to oppose both mergers. The AMA also engaged the National Association of Attorneys General to convince key state attorneys general (AGs) to join the DOJ in opposing the mergers.
To support its arguments, the AMA marshalled leading economists and legal experts as well as conducted extensive physician surveys (in conjunction with state medical association partners) to gauge impact on patient care. The AMA continued to work closely with likeminded stakeholders and led the 17-state medical society coalition in opposing the mergers.
On March 17, 2017, the AMA urged the U.S. Court of Appeals in Washington D.C. in an amicus brief to uphold the trial court’s decision to block the Anthem-CIGNA merger. In its brief, the AMA is arguing (among many other key points) that the trial court properly found that Anthem's reimbursement cuts, rather than enhancing consumer welfare, could cause quality to degrade and consumers to be deprived of choice, and that the evidence at trial echoes what state medical associations learned when they canvassed their members about the likely effects of an Anthem/CIGNA merger. Also, at the AMA’s suggestion, the nation’s experts on antitrust and competition submitted their own amicus brief that supported our contention.