Anthem’s agreement to buy Cigna for $48 billion, if consummated, would cement the dominant position of Georgia’s leading health insurer.
The insurer deal, announced Friday, follows the merger agreement announced earlier this month between two other insurance heavyweights, Aetna and Humana. And both fit into the picture of fast-paced consolidation across the health care industry, partly driven by changes from the Affordable Care Act.
If both consolidations are approved by regulators and shareholders, the national effect would be huge, with the number of large, for-profit health insurers shrinking from five to three.
Indianapolis-based Anthem is the parent company of Blue Cross and Blue Shield of Georgia, which is the big player in the Peach State, with about 3 million members here.
Cigna officials here could not be reached for comment, but one industry estimate put that insurer’s health plan and Medicare membership in Georgia at roughly 600,000. full story
(Updated at 2:15 p.m.)
WellStar Health System, fresh from abandoning a proposed deal with Emory Healthcare, has now landed a new potential partner.
The Marietta-based WellStar is beginning negotiations with Tenet Healthcare to buy Tenet’s five hospitals in Georgia — all in greater metro Atlanta.
North Fulton Hospital
The two organizations issued a statement Thursday confirming the start of “exclusive, non-binding discussions’’ about a potential sale of Tenet’s Atlanta-area hospitals and other facilities to WellStar.
“This is to ensure that these hospitals and facilities are best positioned to meet the needs of their communities and continue delivering high-quality health care for many years to come,’’ said the statement.
WellStar and Tenet declined further comment about the potential deal.
The wave of consolidation in the health care business was also evident elsewhere Thursday, with reports on a looming deal by Anthem to acquire fellow insurer Cigna. full story
The biggest health insurance deal ever was announced earlier this month.
And though it is yet to be reviewed by regulators, the proposed transaction has already prompted concerns about its potential impact in Georgia and elsewhere.
Aetna’s $33 billion acquisition of Humana will get close regulatory scrutiny by state and federal officials over its effect on competition and prices.
Central questions about the deal include:
Will it lead to higher health insurance premiums? Will it contribute to the trend toward limited consumer choice of medical providers?
A deal would substantially affect Georgia, if only because of the numbers of insurance consumers affected. The merger would double Aetna’s enrollment in the state to roughly 1.4 million.
State insurance regulators and the U.S. Department of Justice will review the transaction from a competition standpoint.
The Medical Association of Georgia, meanwhile, said Thursday that it has “grave concerns” about the merger and “is evaluating every option to protect physicians and patients in the state.” full story
An Ohio program that gave insurance to thousands of low-income patients helped them improve on health measures and also produced unexpectedly low costs, according to a study published Tuesday.
MetroHealth Medical Center
Those findings may have a significant impact in Georgia.
State officials are considering a proposal from Grady Health System in Atlanta to extend coverage to uninsured Georgians through a special Medicaid “waiver.’’ Grady officials say the waiver program would be modeled after the Cleveland MetroHealth Care Plus program.
The study, in the journal Health Affairs, analyzed the impact of the Care Plus program, which gave 28,295 Cuyahoga County residents Medicaid coverage for 11 months in 2013. full story
The U.S. Supreme Court, in a 6-3 ruling Thursday, upheld the Affordable Care Act subsidies that have helped millions of Americans, including 412,000 Georgians, obtain insurance coverage.
The ruling was hailed as a huge victory for President Obama and for the ACA, although the constitutionality of the 2010 law was not in dispute in this case.
The justices ruled that federal subsidies can be offered in insurance exchanges run by the federal government, as they are in Georgia and 33 other states.
The plaintiffs in the case argued that the health law did not permit such subsidies in states that have federally operated exchanges. The pointed to the ACA’s language, which says the subsidies are available through an exchange that was “established by the State.”
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John Roberts wrote for the court’s majority. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.” full story