(Bloomberg) -- Aetna Inc.’s agreement to buy Humana Inc. for $37 billion is another link in a chain of U.S. health insurance acquisitions spurred by Obamacare.

The purchase, announced Friday, comes on the heels of yesterday’s announcement by smaller insurer Centene Corp. that it will buy Health Net Inc. for about $6.3 billion.

Read: Centene to buy Health Net in $6.3 billion health-care deal

Obamacare, or the Patient Protection and Affordable Care Act, created millions of new customers for insurance coverage and encourages insurers to look for savings. Aetna’s deal means it will gain more than 14 million Humana customers in commercial, Medicare and Medicaid plans. By purchasing Health Net, Centene creates the biggest private administrator of Medicaid, a federal program for the poor.

Here are other combinations that may be in the works:

*Anthem Inc. may try again for Cigna Corp. The target rejected a $47 billion takeover bid last month. Cigna said the offer wasn’t in the best interest of shareholders and that Anthem executives aren’t fit to lead a merged giant.

*UnitedHealth Group Inc. -- the biggest of the U.S. health insurers -- may try to grab Aetna. Before Aetna announced the Humana purchase, Barclays Plc analyst Joshua Raskin said a UnitedHealth-Aetna combo makes the most sense because of cost savings and the scale it would produce.

*Anthem had weighed a bid for Humana, according to a person familiar with the matter, and could try to outbid Aetna.

*Cigna may try to play the wolf rather than the sheep. Bloomberg reported on June 25 that the company had made an offer for Humana, but that Humana’s board was said to prefer Aetna’s bid.

*UnitedHealth could jump in with a competing offer for Health Net, said Ana Gupte, an analyst at Leerink Partners LLC.

*Further deals among smaller companies may occur. Centene and Health Net’s combination suggests that firms that aren’t among the five biggest will be taken in by the Obamacare-fueled merger frenzy.

--With assistance from Phil Serafino in Paris and Zachary Tracer in New York.

Instant Insights /

Aetna-Humana adds to takeover frenzy among carriers

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