A superficial reading of the latest headlines about the health insurance industry suggests it is facing serious problems, but the steady drumbeat of bad news for insurers is showing up everywhere except in the finances of the major carriers.
Even if the feds bury Anthem's acquisition of Cigna and Aetna's Humana deal, the big five health insurers are likely to forge new transactions to scale up and improve their position at the bargaining table with consolidating hospitals and systems.
Just as the U.S. Justice Department formally moved to block the merger between Humana and Aetna, Humana said it is significantly reducing its individual health plans sold on and off the Affordable Care Act's exchanges.
The government argues both transactions would “substantially lessen competition in numerous markets around the country.” The result, antitrust regulators said, would lead to “higher prices and reduced benefits” for consumers. Both companies plan to challenge the DOJ in court.
The U.S. Justice Department is likely to file lawsuits this month to block Anthem's $53 billion acquisition of Cigna Corp. and Aetna's $37 billion deal for Humana, Bloomberg first reported Tuesday, citing anonymous sources.
Humana's stock price fell by another 2.6% Monday because of investors' fears that the U.S. Justice Department will try to squash Aetna's $37 billion takeover of the insurer.
The latest data on the Affordable Care Act's risk-adjustment program have some small health insurers up in arms.
Data mining of patient medical records kept by the federal government will get a boost by the CMS, following the release of finalized changes to the so-called Qualified Entity Program.
Aetna's acquisition of Humana is creeping toward the finish line, getting an approval early last week from one of California's health insurance regulating bodies. The insurer's approval process stands in stark contrast to Anthem's purchase of Cigna Corp.
Many of the largest carriers sell Medicare supplemental insurance. UnitedHealthcare, the health insurance unit of UnitedHealth Group, dominates the Medigap market because of its relationship with AARP.
Seven Democratic U.S. senators—including Elizabeth Warren of Massachusetts and Richard Blumenthal of Connecticut—have urged the U.S. Justice Department to block the pending health insurance mega-mergers in one of the strongest stances to date against the deals.
The CMS says it's well on its way to dragging hospital systems into the brave new world of risk-based contracting. The systems say, not really.