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Congress eyes health insurer consolidation

Congressional scrutiny of the recent health insurer mega-mergers is a welcome sight, according to B. Douglas Hoey, CEO of the National Community Pharmacists Association.

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Congressional scrutiny of the recent health insurer mega-mergers is a welcome sight, according to B. Douglas Hoey, CEO of the National Community Pharmacists Association.

This summer, health insurer M&As reached a peak with Anthem’s $48 billion purchase of Cigna and Aetna’s $34 billion acquisition of Humana. On Thursday, the House Judiciary Committee’s Subcommittee on Regulatory Reform, Commercial and Antitrust Law held a hearing titled “The State of Competition in the Health Care Marketplace: The Patient Protection and Affordable Care Act’s Impact on Competition”.

“We commend today’s hearing and other efforts by Congress and federal regulators to conduct a thorough examination of the significant consolidation occurring in the health care marketplace, perhaps most notably the proposed Anthem-Cigna and Aetna-Humana mergers,” Hoey said in a statement. “Associations representing hospitals and physicians have expressed concerns that these health insurance mergers could limit patient choice of providers and potentially raise costs. Policymakers cannot allow the ‘merger mania’ gripping the nation to proceed in a way that harms patients and the community pharmacists who serve them.”

In his opening remarks at the hearing, House Judiciary Committee chairman Bob Goodlatte (R., Va.) noted that market consolidation can create the potential for reduced competition and, in turn, the contraction of the related benefits. “It is essential that we preserve as much competition and freedom in the overall health care marketplace as we can,” he said. “We should strive to enact laws that foster competition, so that prices are checked, patients have choices, and the premier quality of American health care can be maintained. Otherwise, costs will go up, choices will narrow, and quality will be diminished.”

Hoey, in his statement, pointed to the fallout that community pharmacies have experienced in the wake of mergers among pharmacy benefit managers (PBMs).

“Already, independent community pharmacies grapple with one-sided, take-it-or-leave-it contract terms from PBM corporations that hamper patient access and the ability of pharmacists to provide top-notch care. Additional consolidation may exacerbate this problem by increasing the disproportionate leverage health insurers have over providers,” he said. “NCPA urges Congress and regulators to be wary of claims by the merging parties that consolidation will necessarily increase efficiencies and drive costs down. It is essential that any purported merger ‘savings’ are in fact passed along to consumers and not simply added to expanding health insurance corporate coffers. NCPA will continue to closely monitor consolidation in the marketplace and take steps to support patient choice and access and the vital role of independent community pharmacists to health care.”

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