April 28, 2017
Area(s) of Interest: Advocacy
A federal appeals court today upheld the lower court’s decision to block the mega-merger between Anthem and Cigna (U.S. v. Anthem Inc., 16-cv-1493). The ruling favored the U.S. Department of Justice (DOJ) and 11 states, including California, who argued that the Anthem-Cigna merger would limit price competition and lower the quality of health care.
In response, the California Medical Association’s (CMA) Senior Vice President and General Counsel Francisco Silva issued the following statement:
“CMA applauds the court’s decision to protect health care access, quality and affordability by blocking Anthem and Cigna’s attempt at further enlarging its already vast market power. CMA has opposed an Anthem-Cigna merger since day one and we are proud of the role that California has played in this decision. This merger would have allowed the merged company to use its massive market power to further limit patients' access to care by creating narrow physician networks and increasing health care costs and patient premiums.”
An overwhelming 85 percent of California’s physicians opposed the Anthem-Cigna merger, according to a 2016 CMA study. Of physicians surveyed from 989 practices, the majority expressed that the merged company 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).
CMA has long been concerned with the consolidation of health plans and health insurers, and the reduction of competition. When market power is consolidated among just a few companies, insurers contract with fewer physicians, limiting choice for patients, increasing wait times for referrals, and sometimes forcing them to pay more to see out-of-network doctors.
Barring an appeal to the U.S. Supreme Court, today’s federal appeals court ruling would represent the final blow the Anthem and Cigna’s proposed merger.