November 21, 2016
Area(s) of Interest: Commercial Payors
On Monday, the U.S. Justice Department (DOJ) and a bipartisan group of state attorneys started court proceedings to block the $48 billion mega-merger between Anthem and Cigna. The merger, if allowed to proceed, would reduce competition and increase health plan market power, compromising patients’ access to care and negatively impacting the quality and affordability of health care across the country.
“The California Medical Association has opposed the Anthem-Cigna mega-merger since day one because it will hurt patients and increase health care costs,” said California Medical Association (CMA) President Ruth E. Haskins, M.D. “Limiting market competition would compel insurers to contract with fewer physicians, resulting in higher premiums and longer wait times for referrals – not to mention forcing many patients to pay more to see out-of-network doctors.”
Seventy-one percent of the nation’s metropolitan areas already lack competitive commercial health insurance markets. A merger between Anthem-Cigna would further diminish competition in 121 metro areas throughout the 14 states where Anthem is licensed to provide commercial coverage.
“When it comes to scope, coverage and quality of health care, what do you trust – the clinical judgment of trained physicians or the corporate policy of insurance companies?” asked Dr. Haskins. “California’s health insurance markets need more competition to ensure that patients receive quality and affordable care.”
In March 2016, a CMA-backed survey of California physicians revealed an overwhelming 85 percent opposed the Anthem-Cigna merger. Out of the 989 physicians surveyed from practices across the state, the majority expressed that the health insurer union could narrow physician networks (82 percent), force physicians to provide fewer services (90 percent) and pressure physicians into refraining from aggressive patient advocacy (75 percent).
The DOJ’s lawsuit is supported by 11 states – including California, New York and Connecticut – and the District of Columbia.