Though recent events have renewed concerns about the prospect of Anthem-Cigna and Aetna-Humana closing on their proposed mergers, both deals have continued to collect approvals from state insurance regulators.
Aetna and Humana have obtained "change of control regulatory approvals" in 15 out of the 20 states it needs so far, an Aetna spokesman confirmed to Forbes contributor Bruce Japsen. Anthem and Cigna, meanwhile, also have faced little state regulatory resistance to their deal, as it has passed muster in 12 of the 26 states needed, Anthem has confirmed.
Even so, the Aetna-Humana deal hit a roadblock this week when Missouri's insurance department issued a preliminary order to block the companies from selling certain insurance products in the state if their deal is finalized.
Missouri's move is particularly impressive given the fact that "Aetna put on the best case possible" during a lengthy hearing about the merits of the merger, antitrust lawyer David Balto tells FierceHealthPayer in an exclusive interview.
The state's decision ultimately could serve as a template for challenges to both deals, he adds, even with the state regulator approvals the companies have won.
"The main battle is before the DOJ and the state attorneys general," Balto says. "This will set a clear roadmap for why these merger should be condemned."
Indeed, both deals face an uphill battle in the effort to gain approval from federal antitrust officials, which are increasingly apt to oppose major mergers out of concern for national competition, as well as less likely to accept typical remedies for anticompetitive effects.
The Anthem deal faces extra hurdles amid reports that the companies have bickered during the merger review process. Anthem CEO Joseph Swedish attempted to mollify worried investors this week, saying "the two teams are working extremely well together" despite a degree of "dynamic tension."
To learn more:
- read the Forbes post