Hospitals driving force behind campaign lobbying against insurer mergers

Editor's Note: This article has been updated to clarify that state medical societies support the Campaign for Consumer Choice and to add a statement from the American Medical Association.

A collection of state-based groups known as the Campaign for Consumer Choice is less a citizen-driven movement against health insurer mergers as it is a hospital industry-funded lobbying campaign, according to a report from STAT.

But an antitrust lawyer involved in the campaign tells FierceHealthPayer that shouldn't surprise anyone.

The Campaign for Consumer Choice was created and funded by the Greater New York Hospital Association and the union SEIU 1199 United Healthcare Workers East, and has also received support from state medical societies. It has set up five similar state-based websites that lay out the Aetna-Humana and Anthem-Cigna mergers' potentially harmful effect on consumers and push for media coverage and public hearings to review the mergers in Connecticut, Virginia, Florida, Ohio and Colorado. 

But David Balto (right), an antitrust lawyer who helped organize the Campaign for Consumer Choice and the Coalition to Protect Patient Choice, tells FierceHealthPayer that it makes sense for consumers and provider groups to work together to lobby against the mergers, as they could negatively impact both.

"The big picture here is that you've got major healthcare provider groups raising significant concerns about these mergers--and appropriately so," he says.

Regardless of where they get their funding, the groups have executed successful grassroots efforts to educate consumers, including town hall meetings about the mergers, he argues.

"The history here is just crystal clear--health insurance mergers lead to higher premiums and greater profits for the health insurers," Balto says. "They benefit the stockholders, not consumers."

Indeed, hospital and physician groups have been fierce opponents of the pending deals, arguing against them in letters to federal regulators and at congressional hearings. Part of their opposition stems from the fact that the mergers would give the large payers more negotiating power over providers, threatening hospitals' bottom lines.

But Jenn Topper, communications director of the Sunlight Foundation, tells STAT that consumers deserve transparency from forces that claim to be working on their behalf. And America's Health Insurance Plans spokeswoman Clare Krusing notes the "irony" of the hospital industry criticizing health insurer mergers when its own consolidation threatens consumers and competition. 

An American Medical Association spokesperson told FierceHealthPayer in an email that the AMA "has no direct or indirect role in the Campaign of Consumer Choice" and that state medical societies are "stand-alone organizations [that] operate autonomously of the AMA."  

To learn more:
- read the STAT article

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