"These gaps really make it so that Georgians can't afford needed health care. If they receive health care, they're left with medical debt, or they have to make really tough…
Today the Department of Justice (DOJ) announced they will file suit to block both the Aetna-Humana and Anthem-Cigna health insurance mergers. Georgia’s attorney general is listed as one of the plaintiffs in the Aetna-Humana case.
Earlier this week we released a policy report, Proceed with Caution: Proposed Health Insurance Mergers Could Harm Georgia Consumers, which details Georgia’s current health insurance market and how these mergers could decrease competition like what happened in California’s Health Insurance Quote, and access to care while increasing prices from many insurance companies, but it may not affect private online companies as InsurancePartnership.org and others.
In light of the DOJ’s announcement, the Georgia Department of Insurance is indefinitely postponing its review of the Aetna-Humana merger and has canceled next week’s hearing. This marks an important milestone victory for Georgia health care consumers and we will keep you posted on any future developments.
In this report, Georgians for a Healthy Future summarizes current insurance market concentration in Georgia, outlines the impact of mergers on premiums and access to health care providers, explains the role of regulators in approving mergers and Georgia’s review process, and provides policy recommendations to protect consumers.
Next week, public hearings will be held on the proposed Aetna-Humana insurance merger. GHF’s health policy analyst Meredith Gonsahn will provide testimony. If you are interested in attending,more details are available and if you have any questions about GHF’s public comments, please reach out to Meredith.
The Georgia Department of Insurance will be holding hearings this summer on two key mergers that could impact the cost, quality, and coverage of health insurance that Georgia consumers are able to obtain.
Three of the nation’s biggest insurance companies (Aetna, Anthem, and Centene) are seeking mergers that would drastically change the health insurance market in Georgia and other states. What’s at stake for consumers is competition. Consumers benefit from competition, it encourages companies to offer lower prices, increase quality, and spur innovation. Currently in Georgia, the top four insurers control at least 75 percent of the market for individual, small group, and Medicare plans sold in the state. If the proposed Aetna-Human and Anthem-Cigna mergers go through then millions of Georgians can expect to see affordability, choice, and access greatly impacted. But Georgia has the opportunity this summer to assess the merits of these mergers and, if approved, to guarantee that negative outcomes for our state’s consumers are mitigated.
State regulators have power to approve mergers
Before the proposed Aetna-Humana and Anthem-Cigna mergers can go into effect in Georgia, both must be approved by the Georgia Office of Insurance and Safety Fire Commissioner (DOI). The DOI began reviewing the two proposed mergers in the summer of 2015. See initial findings for Aetna and Anthem here. After the review process is completed, a public commenting period, which includes a public hearing, will begin. During the public comment period this summer, consumer advocates have the opportunity to provide input and testimony in the public hearings where insurers will be questioned. Following the public hearing, the Commissioner will issue a final decision to approve the mergers as is, approve with conditions, or disapprove.
How consumer advocates can get involved and have their voices heard
- Submit public comments and/or questions on how you believe mergers would affect consumers. Email firstname.lastname@example.org or send by U.S. mail to Administrative Procedure Division, 2 Martin Luther King Jr., Drive, West Tower, Suite 1016, Atlanta, GA 30334
- Attend the hearing on the pending Aetna-Humana and Anthem-Cigna mergers. To receive meeting notifications, subscribe here
- Georgians for a Healthy Future plans to submit public comments and provide testimony. If you would like to learn more about our comments and sign onto them as a partner organization, contact Meredith Gonsahn at email@example.com.
How to ensure that bigger means better for consumers
Georgians for a Healthy Future looks forward to participating in the public commenting process. Over the next month, we will release a policy brief on insurance mergers to help inform our partner organizations and submit public comments to Georgia’s DOI. We will put forth recommendations of merger approval conditions for premium stability, network adequacy, value-based coverage, consumer protections, and regulatory oversight. We recommend that Georgia’s DOI carefully consider whether or not to approve each merger and which remedies best address the expected concerns of and effects on consumers.
Once the mergers are approved they cannot be reversed. Therefore, we urge extreme caution in reviewing whether the mergers should be approved at all. If, at the end of the comment and review period, the DOI has a high degree of certainty that the mergers can benefit consumers, the DOI should set conditions for approval by which insurers should be held accountable to ensure consumers realize these benefits.
Earlier this year, two separate proposed health insurance mergers were announced. A November New York Times article laid out some of the concerns that consumer advocates have about the proposed mergers and featured comments from Cindy Zeldin, Georgians for a Healthy Future’s Executive Director. Our Health Policy Analyst Meredith Gonsahn is monitoring this important issue – be on the lookout for a policy brief in the new year that provides more detailed insights about the potential effects of these mergers. You can also learn more by visiting the Coalition to Protect Patient Choice.