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Nearly twenty-two million Medicare beneficiaries are enrolled in government-financed private plans, collectively known as Medicare Advantage. 137 There are serious concerns that the proposed insurance mergers would extremely consolidate an already concentrated Medicare Advantage Plans market. In August 2015, the Commonwealth Fund published a study finding that ninety-seven percent of Medicare Advantage markets are already highly concentrated. 138 The study concluded that in two- thirds of the 100 countries with the highest Medicare beneficiaries, insurer market power was concentrated to just three national insurers. 139 Humana currently serves over three million Medicare beneficiaries. 140 Kaiser Family Foundation found that if Aetna and Humana are allowed to merge, the new company would become the largest Medicare Advantage insurer, covering over one quarter of Medicare Advantage enrollees.141 These insurers looking to merge already have dominance over Medicare Advantage plans, but that dominance will only grow under the proposed merger. For example, if Aetna goes through with purchasing Humana, the newly-created company will serve ninety percent of Kansas Medicare Advantage patients.142 The ACA and Medicare Advantage only work with competition. The lack of competition that stems from consolidation could force those healthcare plans to become unaffordable.143 While insurance companies argue mergers will result in “no material change to competition in market,”144 providers are asking the Department of Justice (DOJ) to heavily scrutinize the effect consolidations would have on Medicare Advantage providers.145 The American Hospital Association (AHA) argues these consolidations trigger
137. Dafny, supra note 22. 138. Brian Biles et al., Competition Among Medicare’s Private Health Plans: Does It Really Exist?, 25 COMMONWEALTH FUND 1, 4 (Aug. 25, 2015), http://www.common wealthfund.org/~/media/files/publications/issue-brief/2015/aug/1832_biles_ competition_medicare_private_plans_ib_v2.pdf. 139. Id. at 1. 140. Robert Cyran, Regulatory Hurdles to Health Insurance Mergers, N.Y. TIMES (July 24, 2015), http://www.nytimes.com/2015/09/23/business/aetna-anthem-congress- health-insurers-mergers.html?_r=0. 141. Gretchen Jacobson et al., Data Note: Medicare Advantage Plan by Firm, 2015, KAISER FAM. FOUND. (July 14, 2015), http://kff.org/medicare/issue-brief/data-note-medicare- advantage-enrollment-by-firm-2015/. 142. Cyran, supra note 140. 143. Robert I. Field et al., What Do Health Insurance Mergers Mean for You?, PHILLY.COM (Sept. 17, 2015, 12:05 PM), http://www.philly.com/philly/blogs/health- cents/ What-do-health-insurance-mergers-mean-for-you.html. 144. Robert Pear, supra note 127 (quoting Congressional testimony of CEO of Humana describing company as a “large Medicare company” serving over three million Medicare beneficiaries). 145. AHA Letter to DOJ, supra note 90.