Anthem Inc.’s proposed merger with Cigna Corp.would reduce health-care competition and raise costs for consumers,U.S. antitrust lawyers will argue Monday when the government goesto court to block the transaction.

Their $48 billion merger -- the biggest in the history of theAmerican health-insurance industry -- would likely give theenlarged company the power to raise prices for insurance, cutpayments to doctors and reduce the quality of service, the JusticeDepartment has said in court papers.

Anthem counters that by buying Cigna it would be able to lowerreimbursement rates to health-care providers. Those savings wouldbe passed on to employers and policyholders,the Indianapolis-based company says.

The Justice Department’s lawsuit opposing the Anthem-Cignamerger is one of two health-care antitrust cases going to trial inthe waning days of the Obama administration as it tries to preventthat industry from shrinking to three national carriers from five.The second case, against the $38 billion tie-up of Aetna Inc. andHumana Inc., opens before another judge in Washington on Dec.5.

By challenging the deals earlier this year, President BarackObama’s administration seized an opportunity to further shape thefuture of health care after passage of the Affordable Care Act.

New administration

President-elect Donald Trump has said his administration will bemore pro-business than his predecessor’s, but he has also said hewould block AT&T Inc.’s plan to buy Time Warner Inc. Trump, whois to take office on Jan. 20, said Friday that he would nominateSenator Jeff Sessions to be attorney general.The Alabama Republicandoesn’t have a clear track record on antitrust issues, leaving hisapproach to competition preservation unclear.

The government said in its complaint that Anthem’s deal for Cigna would hurt competitionfor millions of consumers who receive commercial insurance fromnational employers as well as large-group employers in at least 35metropolitan areas, including New York.

The run-up to the Anthem-Cigna trial was marked by acrimonybetween the companies, with each accusing the other of breachingterms of their deal. Cigna stands to collect a $1.85 billion breakup fee if the merger is blocked.

Last month, the U.S. won an order compelling the companies toturn over written correspondence between the two, which thegovernment argued was relevant to combating the carriers’ claimsthat their combination would create a more efficient company. TheU.S. could use those letters as evidence during the trial.

“Governance disputes between defendants have escalated, and thefirms are now accusing each other of breaching the mergeragreement,” the U.S. said in court papers. “Because the breachletters reveal the current state of hostility between defendants,the letters evince barriers to integrating these firms and arerelevant” to the defenses raised by the companies.

Two phases

The trial is scheduled to last more than a month, in two phases.In the first, the U.S. will attempt to prove that the combinedcompany would hurt large national employers. The second phase, setto start Dec. 12, will focus on the proposed tie-up’s effect onlocal markets.

Backing the Justice Department are 11 states, including NewYork, California and Connecticut, plus the District ofColumbia.

Anthem had pushed the judge for a trial scheduled to finish bythe end of the year so it has time to get state regulatoryapprovals by the merger deadline of April 30.

The case is U.S. v. Anthem Inc., 16-cv-1493, U.S. DistrictCourt, District of Columbia (Washington).

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