It’s not just the federal government that wants a say in two proposed mega-mergers in the health care industry.

Fifteen state attorneys general are joining a federal probe into Aetna’s plans to buy Humana and Anthem’s plans to acquire Cigna.

Sources have told Reuters that authorities from Connecticut, Florida, Massachusetts, Tennessee and Iowa are investigating the mergers, which have both been approved by shareholders but are still awaiting approval from federal regulators. Reuters couldn’t track down the other 10 states involved.

Those five states offer an interesting glimpse at the bipartisan concerns of an uncompetitive insurance marketplace. The attorneys general for Florida and Tennessee are both Republicans, while those for the three other states are Democrats.

Because each state is a separate insurance market, the increasing consolidation of insurers could have an outsized impact in certain states.

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For now, the insurers are projecting confidence in the process. Anthem CEO Joseph Swedish told Reuters that he welcomed the participation of state authorities in the review of the mergers.

“The states created this path with the DOJ (Justice Department) to promote education, engagement. They develop a lot of insights so that when the DOJ does rule, our work with all of these states is probably enhanced quite a bit because we are not starting from scratch,” he said.

Aetna released a similar statement: "We are confident that our transaction will receive a fair, thorough and fact-based review from the Department of Justice and the states,” it said.

A number of influential groups have expressed skepticism, if not outright opposition, to the proposed deals. The American Medical Association has urged the federal government to block both deals, arguing that the future market share of the newly-formed companies in 97 metropolitan areas and 17 states would exceed that allowed by federal anti-trust guidelines.

So far, Hillary Clinton, the leading Democratic candidate for president, has voiced concerns but stopped short of calling for the Justice Department to kill the deal.

Instant Insights /

More state attorneys general join probe of insurance mergers

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