The American Medical Association released a study today finding the proposed Anthem-Cigna and Aetna-Humana mergers could lessen competition in up to 154 metropolitan areas across 23 states.
Individually, the AMA says the Anthem-Cigna deal could reduce competition in up to 111 metropolitan areas in all 14 states Anthem currently operates, while the Aetna-Humana merger would lessen competition in up to 58 metro areas across 14 states.
The AMA said the prospect of five national health insurance carriers shrinking to three "should be viewed in the context of the unprecedented lack of competition that already exists in most health insurance markets." The analysis found 14 states had a single health insurer with at least 50 percent share of the commercial health insurance market, while 46 states had two insurers with at least 50 percent share of the commercial market.
The AMA has analyzed insurance competition for 15 years. The latest edition of its report studies competition in 388 metro areas as well as all states and Washington, D.C., based on 2013 data.
AMA President Steven J. Stack, MD, said the association is urging federal and state regulators to review the proposed deals and use enforcement tools to preserve competition.
"A lack of competition in health insurer markets is not in the best interests of patients or physicians," Dr. 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."