Federal regulators may ultimately approve the mega-merger of Aetna and Humana, but the resulting insurance behemoth will not be welcome to do certain business in Missouri.
However, Aetna and Humana have 30 days to “submit a plan to remedy the anti-competitive impact of the acquisition.” That likely means the state may push the health insurers to divest Medicare Advantage plans in areas where competition would have been smothered.
Most provider groups in Missouri, including the Missouri Hospital Association and the Missouri State Medical Association, filed statements opposing the Aetna deal. However, some individual providers such as Freeman Health System in Joplin, Mo., and Encompass Medical Group in Kansas City, Mo., actually supported the merger.
Missouri officials were most worried that competition in Medicare Advantage—Humana’s primary business and the key reason why Aetna struck the deal—would be stifled and therefore hurt seniors in the form of higher premiums. Aetna and Humana, combined, control 54% of the individual Medicare Advantage market in Missouri and 30% of the group Medicare Advantage market. There are 23 counties in Missouri where Aetna and Humana have more than 80% of the individual Medicare Advantage market.
Source: Modern Healthcare