AMA Study: Health Insurer Mergers Will Harm Patients

Massive insurance company mergers will diminish competition and have harmful consequences for patients across the country, according to a new study from the American Medical Association, which is urging federal regulators to proceed with care as they review the proposals.

If two proposed mega-mergers in the health insurance industry are approved by federal regulators, it will be bad news for patients in more than 150 metropolitan areas in 23 states, the American Medical Association argues in a new report.

Aetna’s plan to buy Humana and Anthem’s proposed purchase of Cigna Corp.—currently under antitrust review by the U.S. Department of Justice and state insurance officials—will diminish affordability, access, and competition in the medical insurance marketplace, the AMA says in the report, Competition in Health Insurance: A Comprehensive Study of U.S. Markets.

“If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums,” AMA President Dr. Steven Stack said in a press release last week. “Physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care.”

If  the mergers are approved, AMA notes, the number of national health insurance carriers in the U.S. would be reduced from five to three.

AMA notes that competition is already limited in 46 states, where two health insurers represent 50 percent of the local markets. In 14 states, a single insurer represents nearly half of the local market.

The mergers would exacerbate the issue, creating mergers that would break federal antitrust guidelines in 97 metro areas in 17 states, the study concludes. AMA added that the mergers could impede the goals of the Affordable Care Act, which relies on an open marketplace to be successful.

In comments to The New York Times, Stack recommended that regulators look at the mergers in detail, since “a lack of competition in health insurer markets is not in the best interests of patients or physicians.”

The AMA study echoes concerns about the mergers raised in August by the American Hospital Association.


Patrick deHahn

By Patrick deHahn

Patrick deHahn is a contributor to Associations Now. MORE

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