Patient Support & Advocacy

Rumblings of possible Anthem-DOJ settlement are cause for “alarm”

Troy Parks , News Writer

Tales about a potential resolution that would allow health insurance Goliaths Anthem and Cigna to merge have sparked the AMA to urge the U.S. Department of Justice (DOJ) to reject any offers to settle the Anthem-Cigna litigation.

U.S. District Judge Amy Berman Jackson blocked the Anthem-Cigna merger in a Feb. 8 ruling, but an Anthem attorney recently made a statement in Delaware court suggesting “two pathways” for the merger to proceed. “One is through appeal and the other is through resolution with a new DOJ,” the attorney, Glenn M. Kurtz, said. Kurtz also said in court that Vice President Mike Pence “was supportive of the transaction as governor of Indiana.”

In a letter to Acting Assistant U.S. Attorney General Brent Snyder, AMA CEO and Executive Vice President James L. Madara, MD, expressed “alarm” regarding the statements and noted “press reports of settlement negotiations.” Meanwhile, Bloomberg Law reported that a former Anthem Inc. registered lobbyist, Makan Delrahim, is working as deputy counsel in the White House and is a contender to head the DOJ’s antitrust division.

“We find it implausible that the U.S. Department of Justice, 11 states, and the District of Columbia—that have diligently and successfully prosecuted this antitrust merger case—could now be swayed to allow this merger to close pursuant to politically driven settlement negotiations as Anthem has suggested,” Dr. Madara wrote. “To do so would cause irreparable harm to the integrity of the federal courts to adjudicate anticompetitive behavior in a fair and impartial manner, leaving consumers at risk. We strongly believe that political influence should play no role in the enforcement of the antitrust laws and urge you to vigorously defend Judge Jackson’s ruling.”

For nearly two years, the AMA has fought the proposed Anthem-Cigna merger, along with the merger of Aetna and Human also blocked in federal court, on the grounds they would adversely affect health care access, quality and affordability for consumers. The AMA’s efforts include updating its gold-standard study of health-insurance competition, preparing state-specific market analysis of the Anthem-Cigna and Aetna-Humana mergers, and sending comprehensive, evidence-based advocacy letters to the DOJ and state regulators.

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The AMA also led a 17-state medical society coalition, communicated with like-minded stakeholders, engaged the National Association of Attorneys General to convince key state AGs to join the DOJ in blocking the mergers, conducted physician surveys in conjunction with state medical association partners to gauge the patient-care impact, and marshaled nationally recognized economists and legal experts

“We believe the evidence presented to the District Court is compelling and that blocking the proposed merger in its entirety is the only way to adequately protect patients and physicians from the anti-competitive effects of an Anthem-Cigna merger,” Dr. Madara added in his Feb. 28 letter to Snyder. “Without the steadfast opposition of the DOJ and state government plaintiffs, the merger of Anthem and Cigna—presently the nation’s second and third largest health insurer carriers—would have created the single largest seller of health insurance to large commercial accounts in a market in which there are only four national carriers remaining.”