Anthem says the
The other national account arrangement is where a few giant employers let an insurer like Aetna predict how much health care employees will need, and quote a price based on that.
The DOJ sued in July to block the proposed
The antitrust regulators wrote in their brief that they "are not required to show that Anthem will increase prices, decrease provider reimbursement, or cause the quality of medical care to diminish." Instead, they said, if the merger increases market share for the combined company in an already concentrated market, the presumption the judge should draw is that it's illegal.
Anthem contends that the government's argument that a larger Anthem would contain costs at health care providers is proof that the merger is good for consumers. It says that companies like Coca-Cola, which pay health care bills directly, will be the beneficiaries of lower reimbursement rates negotiated by Anthem.
"This is an extraordinary action in which federal and state competition authorities, are, according to their own allegations, seeking to deprive American consumers of lower health care costs," Anthem's lawyers wrote.
And, Anthem says, the government ignores that Anthem is not a national insurer now, with a national network. It is a regional insurer, with operations in 14 states, and when national employers want to provide health insurance to employees outside those states, Anthem rents health care networks for a fee from nonprofit
"A prime reason for the proposed merger is to provide Anthem with Cigna's nationwide network so that Anthem may for the first time become a true nationwide competitor," Anthem lawyers wrote.
"At trial, Anthem will establish that customers do not consider Cigna to be the closest substitute for Anthem; in fact, Anthem's closest competitor is
They said the fact that employers can choose from a true national network like Aetna's or a regional player that rents networks from others shows that becoming larger would not guarantee that Anthem would have monopoly pricing power when selling to companies with national employee footprints.
They said the case ignores that "the most sophisticated and resourceful commercial enterprises in the world would have a multitude of options to defeat any attempted price increase by the hypothetical monopolist.
"The complaint seems to assume that the nation's biggest corporations would meekly submit to an attempted price increase by nationwide-network insurers. Evidence and reason suggest otherwise."
The government lawyers argued that even if the judge disagrees that Anthem would have the ability to charge more without losing customers, she should still block the merger because the law also bars monopoly power that applies to what companies buy -- in this case, medical services the end customers receive.
The DOJ claims it only has to prove that Anthem's bargaining leverage will increase. Their side does not have to "take the extra step of proving that ... lower rates will restrict access to medical care, reduce the quality of medical care, or otherwise harm patients."
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