The healthcare payers involved in the pending mergers claim the deals would bode well for the Affordable Care Act's exchanges, yet antitrust regulators may block the deals, according to Forbes.
Here are five points:
1. Last week, Anthem CEO Joe Swedish said the company's plan to purchase Cigna would allow Anthem to offer more coverage under the ACA. Anthem said it plans to add nine states in the ACA exchanges if its deal with Cigna passes.
2. Cigna would have deployable cash totaling $5 billion if its deal with Anthem does not go through, with the payer giving no indication it would use that money toward bolstering its products on the public exchanges.
3. Aetna and Humana also claimed their merger would expand ACA coverage, although their dedication to the public exchanges may not hold true if the deal fails to come to fruition. Humana lost $1 billion losses on ACA exchanges last year.
4. Due to the steep losses, Humana said in July it would participate in "no more" than 11 state marketplaces in 2017.
5. Aetna has said it sees potential in the ACA exchanges, but would like to see the government change how they assemble the risk pools. The company's chief executive Mark Bertolini said he would like to see the government collaborate with payers to improve the risk pools and make changes to give payers more flexibility in the types of plans they offer.
More articles on coding & billing:
The shift from grouper to APC reimbursement: Advice for ASCs and HOPDs
Anthem to add 9 ACA exchanges if Cigna deal passes: 4 takeaways
5 trends in healthcare payment reform: Does price transparency help or hurt?