Aetna’s 2015 revenues rose past the $60 billion mark–but the 23-million member strong health insurer has its sights set much higher. Its proposed $37 billion merger with rival Humana would birth a health insurance giant with dominance in the Medicare Advantage managed care space second only to UnitedHealth Group and give its pharmacy benefit unit access to patients who use more than 600 million prescriptions every year. Such a union would also transform Aetna from the primarily employer-based group insurance firm into one that focuses on individuals. The company will have to wade through significant regulatory hurdles and medical industry blowback in its quest. In May 2016, attendees at the American Hospital Association’s annual meeting warned that deals like the Aetna-Humana partnership would burden hospitals and consumers by giving insurance giants inordinate market power despite the companies’ promise to make significant divestitures. State insurance commissioners like California’s Dave Jones have also expressed deep skepticism about the merger in recent months. The question of whether or not to remain in Obamacare’s individual marketplaces has also weighed heavily on insurance companies in recent months, with UnitedHealth announcing that it would exit most statewide exchanges next year. Aetna CEO Mark Bertolini has taken a different tact, arguing his firm has “an obligation to stick it out and work with it until we know that it won’t work” and may even expand its Obamacare presence (the position puts him somewhat at odds with Humana’s recent pronouncement that the firm may ditch the health law marketplaces in some states after a 46% decline in quarterly profits).
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