Sept. 08--The proposed mergers among the nation's largest health insurers raise antitrust issues and warrant careful review, the American Medical Association said Tuesday.
The Chicago-based doctors group said the combinations of Anthem and Cigna, and Aetna with Humana could reduce competition in up to 154 cities in 23 states, including Illinois.
"A lack of competition in health insurer markets is not in the best interests of patients or physicians," AMA President Dr. Steven Stack said in a statement. "If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums, and physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care."
The AMA joined the American Hospital Association in criticizing the proposed mergers. The hospital trade association said last week that the Aetna-Humana deal would further concentrate the business of selling private Medicare plans to seniors. More than 30 percent of Medicare beneficiaries have enrolled in such private plans, which provide an alternative to traditional Medicare.
The associations' concerns are hardly surprising because doctors and hospitals have long fought with insurance companies over payments. Larger insurance companies created through mergers could have more leverage in future negotiations with providers. The insurers involved in the deals have said that the consolidation would reduce costs and increase efficiencies.
Consolidation also is sweeping the hospital industry. In addition, hospitals are acquiring physician groups to increase their revenues.
The U.S. Justice Department has geared up to examine the insurance mergers to see if they would benefit consumers.
In Illinois, the AMA found that the Aetna-Humana merger would concentrate the market in Rockford. The finding is consistent with data analyzed by the Kaiser Family Foundation in the private Medicare market.
asachdev@tribpub.com
