Victory: Judge Blocks Aetna-Humana Merger

Jan 25, 2017 at 11:22 pm by Staff


From the American Medical Association

Presented by OCMS/SCMS

In a landmark win January 23 for organized medicine and the nation's patients, federal judge John D. Bates blocked the proposed Aetna-Humana merger. The judge found that the merger would have substantially lessened competition in Medicare Advantage and commercial health insurance markets. This is an extraordinarily well documented, comprehensive, fact-based ruling by U.S. District Judge John D. Bates, which acknowledges that meaningful action was needed to preserve competition and protect high-quality medical care from unprecedented market power that Aetna would acquire from the merger deal. The decision is a historic, stunning affirmation of the position urged by the American Medical Association (AMA) and the 17-state medical association antitrust coalition members. The court's ruling sets a notable legal precedent by recognizing Medicare Advantage as a separate and distinct market that does not compete with traditional Medicare. This was a view advocated by the AMA, as well as leading economists.

The AMA and its coalition partners worked tirelessly to oppose this merger: sending comprehensive, evidence-based advocacy letters to the US Department of Justice (DOJ) and state regulators after the merger was announced in July 2015; engaging like-minded stakeholders like the American Hospital Association and various patient coalitions, as well as the National Association of Attorneys General; conducting extensive physician surveys to gauge physician concern about the merger and presenting the DOJ and state regulators with compelling survey results; testifying in or submitting memoranda in various state insurance department hearings and/or attorney general investigations, and making that, and other evidence and testimony, available to the DOJ and state regulators; securing outside experts to buttress our arguments and strip down those of the insurers -- all demonstrating how the merger would harm patients and physicians.

We want to take this opportunity to thank all of our coalition partners for helping us achieve this historic victory on behalf of our physician members and their patients. Our collective work on these mergers is, without a doubt, a model for future advocacy success.

Sections: Grand Rounds





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