AHA to Congress: Health insurance consolidation could harm consumers, providers
Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana “would further concentrate an already heavily concentrated health insurance industry by eliminating two of the largest five insurers, and result in negative consequences for both health care consumers and providers,” AHA Executive Vice President Tom Nickels Sept. 29 told the House Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law.
Testifying at a hearing on the proposed health insurance deals and their impact on competition, Nickels highlighted the lack of competition in local commercial insurance markets and high barriers to entry for new insurers, concerns that further concentration would lead to higher out-of-pocket costs and fewer benefits for Medicare Advantage enrollees, and how the deals could derail the hospital-led momentum to improve the nation’s health care delivery system, among other concerns.
The proposed deals “could be an enduring blow to consumers as well hospitals, doctors and others who work to improve the quality, efficiency and affordability of health care,” Nickels said in his prepared testimony.
“Hospitals’ momentum to move the nation’s health care system forward could also sustain long-term irreversible damage as a result of these deals,” Nickels testified. He said commercial insurers “continue to benefit financially from letting hospitals do most of the hard work of reducing readmissions, improving patient quality, experimenting with accountable care organizations and bundling programs, instituting population health programs and numerous other efforts designed to turn a system predicated on volume to one measured by value.”
Representatives from Anthem, Aetna, the American Medical Association and others also testified at the hearing.
Earlier in September, the AHA testified before this House subcommittee on competition in the health care marketplace, and two weeks ago it testified at a Senate hearing on health insurance consolidation.
As in its previous testimony on Capitol Hill, the AHA drew a sharp distinction between the realignment taking place in the hospital and health system field and the consolidation proposed in the health insurance industry.
Nickels said hospitals and health systems are realigning so patients have convenient access to care. They are coordinating with caregivers to deliver care that is more patient centered and teaming up with other providers to unify patient information, coordinate transitions and follow-up care, he told the House subcommittee.
He reiterated the AHA’s view that the Department of Justice should be “ready to challenge the insurance deals, if, as we expect, its intensive investigation confirms that these transactions threaten the growth and vitality of our health care system and the health and welfare of consumers across the nation.”
For more on the AHA’s testimony, see the AHASTAT blog post.