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While the debates over Obamacare have faded into the rear view mirror of public discourse, another major crossroads lies ahead as health insurance giant Anthem has unveiled plans to merge with Cigna in a $54 billion deal. Health care industry specialists cannot agree on whether bigger is better when it comes to this pending health care merger.

This month, Denver Post health care reporter David Olinger laid out the debate around the Anthem-Cigna merger. Insurance Commissioners and Attorney Generals across the country are reviewing this merger, along with another merger of Aetna and Humana, according to state laws that govern the consumer protections around health insurance.

While millions more Americans now have insurance, the prospects of everyone getting quality affordable health care—particularly in underserved communities—is are still unclear. Many people underutilize their insurance because the process is too complex. Some stop paying for their insurance plans shortly after they get covered. Colorado’s health exchange recently went through a shutdown of the non-profit health care co-op and the departure of United Health Care from the market.

So amidst all of this complexity, how are we to figure out whether these health insurance mega-mergers going to impact the average person?

Here are five questions that should be answered before the merger is approved or denied by the Colorado Division of Insurance (DOI), which regulates the insurance industry in our state.

1. The merger may be good for Anthem, but is it good for Colorado?

The merger would increase Anthem’s bottom line by billions of dollars. Yes, that is good for Anthem, but it doesn’t benefit Coloradans. For instance, different insurance companies have different approaches to coverage for transgender people. In fact, these two companies differ in how they treat this population—which policy will they adopt?

The Colorado Medical Society has opposed this merger. How will their voice be incorporated into this discussion? Will the health care choices of Coloradans be limited?

2. What does Connect for Health Colorado (the health insurance marketplace) think about this merger?

Colorado Connect for Health is the state’s marketplace for affordable health care, commonly known as “Obamacare.” Its mission, clearly stated on its website, is “to increase access, affordability, and choice for individuals and small employers purchasing health insurance in Colorado.”

The pending merger would cut one more insurer out of the market giving Colorado consumers one less option in selecting a health care provider. Is that a good idea? While the DOI considers this merger, the Colorado Exchange is a crucial voice in this debate. Have they discussed this issue at any of their public board meetings? Anthem has a seat on the board of the exchange.

3. What about rural health care providers and their patients?

Doctors are scarce in some rural communities. These doctors or sole practitioners could be forced out of health care networks, raising health care costs for some communities that continue to face economic challenges. Will rural communities suffer?

4. What will this do to indigent care?

The Colorado Indigent Care Program is funded with federal and state dollars to partially compensate participating providers who provide health care to the uninsured and underinsured.

The question remains: How will Anthem-Cigna merger impact Colorado’s low-income families who are dependent on this program?

5. Should there be a public conversation about this?

Yes. I applaud Division of Insurance Commissioner Marguerite Salazar for pledging to hold a public hearing on the Anthem-Cigna merger. However, the regulations offer a comment period of only 30 days—is that enough time?

Discussions at the hearing must address the important questions raised above. And, we as a community have a responsibility to participate in the public hearing and let the Commissioner know that we care about our health care providers and how they treat us.

What questions do you think need to be asked? Please leave a comment below or get involved here.


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