In the face of mergers between major national health insurers, physicians Tuesday during the 2015 AMA Interim Meeting said the medical profession will continue to stand against health insurance market consolidation that enhances health insurer market power, a trend that decreases health care access, quality and affordability.
Adopting new AMA policy, physicians emphasized the need for active opposition of consolidation in the health insurance industry that may result in anticompetitive markets.
“The AMA strongly opposes these mergers as they would erode competition, causing patients and employers to pay higher premiums and forcing physicians to accept terms that will degrade their ability to provide patients with high-quality health care,” AMA Immediate-Past Chair Barbara A. McAneny, MD, said in a news release. “We urge the federal government to stop these mergers and protect consumers and physicians from the harm that would result from a lack of choice in health insurance plans.”
How physicians already have taken a stand
Even before adopting the new policy, physicians have been far from silent on this issue. For years the AMA has issued a comprehensive annual study on competition in health insurance markets in the United States. The latest edition was released in early September and included special analyses of the proposed mergers between Anthem and Cigna and between Aetna and Humana.
The analyses concluded that the mergers would exceed federal antitrust guidelines designed to preserve competition in as many as 97 metropolitan areas within 17 states. The mergers also would raise significant competitive concerns in additional areas. All told, nearly one-half of all states could see diminished competition in local health insurance markets.
The study and analyses were created to help researchers, lawmakers, policymakers and regulators identify markets where mergers and acquisitions among health insurers may harm patients, physicians and employers.
Also in September, members of the AMA Board of Trustees testified in two different congressional hearings:
- On Sept. 10, Dr. Barbara L. McAneny delivered testimony during a hearing on the state of competition in the health care marketplace. Dr. McAneny told members of Congress, “Providing patients with more choices for health care services and coverage stimulates innovation and incentivizes improved care, lower costs and expanded access.”
- On. Sept. 29, AMA President-Elect Andrew W. Gurman, MD, testified at a hearing on examining the proposed health insurance mergers and the consequent impact on competition. Dr. Gurman urged federal and state regulators “to closely scrutinize the proposed health insurer mergers and utilize enforcement tools to protect consumers and preserve competition.”
Last week, the AMA sent a letter to the U.S. Assistant Attorney General, calling on the U.S. Department of Justice to “block the proposed mergers.” The letter emphasizes that “fostering competition, not consolidation, benefits American consumers through lower prices, better quality and greater choice.”
Building on its work with the National Association of Attorneys General, the AMA will present to a majority of state attorneys general later this month. The testimony will highlight findings from the AMA’s competition study and emphasize the importance of blocking mergers, such as those between the four major national insurers that are in the works.
The AMA also is offering its continued assistance to state medical associations around the country as they assess how to position themselves regarding the proposed mergers and the actions of their state regulatory agencies.