Insurance giants are consolidating – Aetna is seeking to acquire Humana and Anthem is seeking to acquire Cigna.  David Balto, a top anti-trust expert in this area who is working closely with advocates in a number of states to challenge these mergers, characterized what’s happening on UHCAN’s 6/7/16 national call:

The economic history tells a powerful and compelling story. When insurers merge, consumers pay more. Premiums go up significantly, the networks are narrowed, and doctors are forced into assembly-line health care.  The number of competitors clearly impacts how much consumers pay.  Allowing five industry giants to become three, which is what these two sets of mergers will do, will be a horrible recipe for consumers.

These mergers are being reviewed by the federal Anti-Trust Division of the Department of Justice, but they must also be reviewed and approved by insurance commissioners and, in some cases, state attorneys general, in those states where the companies involved are doing business. Each state is approaching these mergers differently.  Even in states where at least one of these insurers has thousands of customers, there is wide variation in how decisions are made, ranging from holding robust public hearings to making decisions behind closed doors.

ACTION: Here are some ways health care justice groups can act to influence their investigations and decisions at both levels, and raise public awareness of what’s going on in the process:

1) Find out what is happening in your state.  Check out this comprehensive list on Consumers Union Health Care Value Hub, or, look at the map on the home page of the Coalition to Protect Patient Choice.  If you have questions or information to share, contact:

Michael DeLong, Law Offices of David Balto,, T:925-708-1135, or,
Lynn Quincy, Consumers Union Health Care Value Hub,, T: 202.462.6262

2) Organize a sign-on letter to demand a public hearing. if a merger is still under review in your state. A hearing is a great forum for patients, advocates and health providers to testify about how the merger would impact them.  It’s an opportunity to build a coalition to push back on the profiteering of the insurance industry. The law office of David Balto is assisting advocates with drafts for sign-on letters and will provide expert testimony, too.  States that have sent letters to date are:  CA, DE, FL, IA, IN, MO, NY, VA, WI.  Public hearings have been held already in some states, like Florida, California, Missouri, Virginia – see news from all the states HERE.

** MISSOURI: Missouri’s Insurance Commissioner has initially denied approval of the Aetna-Humana merger – see the website of Missouri Health Care for All and this article from the St. Louis Post Dispatch.

** CALIFORNIA: Health Access has a “Merger Watch” page on their website tracking developments in California:

Hearings are pending in several states, including Colorado, Connecticut, Georgia and New Hampshire for the Anthem-Cigna merger.

3) Challenge secret approvals of mergers.  In Connecticut and Ohio, and perhaps some other states we don’t know about yet, insurance commissioners are approving these mergers in secret.  There is a behind-the-scenes coordinated campaign to facilitate the Anthem-Cigna merger, occurring with the full knowledge of the National Association of Insurance Commissioners (NAIC) orchestrated by Connecticut’s Insurance Commissioner as documented in the stunning expose in International Business Times (see below) and denounced by the Hartford Courant which is usually a pro-industry paper (also below).

** Tom Swan from Connecticut Citizen Action Group urges states where a merger has been approved to ask your commissioner if the scandal in Connecticut has any bearing on what’s happening in your state.  Contact Tom for more information: or Connecticut-based UHCAN Board member, Jill Zorn at

Will Cigna and Anthem merge? How Health Insurance Companies Pump Money Into Politics (David Sirota, 6/1/16, International Business Times)
Insurance Commissioner Katharine Wade Mishandles Health Insurance Mergers  (St. Louis Post Dispatch)

** UHCAN Ohio responded today to the completely startling news that the Ohio Insurance Commissioner secretly approved the merger of Aetna and Humana one month ago: Ohio Department of Insurance Approved Aetna-Humana Merger with Little Public Notice.

Note: A national sign-on letter to the federal Department of Justice may be forthcoming.