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Aetna, Humana Insurance Merger Could Hurt Competition in Illinois, AMA Says

Aimee Sharp
Author | Shield HealthCare
09/23/16  2:29 PM PST
Aetna, Humana insurance merger

By Lisa Schencker for the Chicago Tribune

A merger between insurance giants Aetna and Humana could threaten the quality and affordability of health care in Illinois and 14 other states, according to an American Medical Association analysis released Wednesday.

Aetna and Humana say they want to combine to offer better access to higher quality affordable care. But the Chicago-based AMA has been a vocal opponent of the deal, arguing it will lead to less competition among insurers and, in turn, fewer choices for consumers, at higher costs.

Illinois has joined the U.S. Department of Justice in a lawsuit seeking to halt Aetna’s proposed $37 billion acquisition of Humana. The Justice Department also is suing to block a proposed deal between insurers Anthem and Cigna. The medical association did not cite any competition issues with regard to that merger in Illinois in its analysis.

In Illinois, an Aetna-Humana merger raises competitive concerns across the state involving insurers offering PPO plans, according to the AMA analysis. The group said a merger also could harm competition in the Rockford, Bloomington-Normal, Kankakee-Bradley and Lake County-Kenosha County areas when one looks at the combined markets for PPOs, HMOs, plans offered on the Obamacare exchange and point of service plans.

“When markets like this consolidate, the premiums go up and choices of care go down,” said Dr. William Kobler, an AMA board member and family physician in Rockford.

He said physicians already have little bargaining power with big insurers, and consolidation will only make that worse.

“If we want to have access to those patients and keep our doors open, we’re pretty much stuck with what the insurance company is telling us to do,” Kobler said. Across the country, hospitals and physician groups also have been consolidating.

But Aetna spokeswoman Kristine Grow said Wednesday the deal will offer more choices to consumers and greater access to higher quality, more affordable care. She said the deal is mainly about Medicare Advantage — Medicare plans offered by private insurers — not the commercial products the AMA study analyzed. The AMA looked at nongovernmental PPOs, HMOs, plans offered on the Obamacare exchange and point of service plans.

Read the Full Article on the Chicago Tribune‘s site.


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