Health Plan Weekly

Ending nearly a year of “will-they-or-won’t-they” speculation, The Cigna Group on Nov. 11 confirmed it is not pursuing an acquisition of Humana Inc., thus ending the possibility of a “Cigmana,” as some analysts called it.

In a press release outlining its capital priorities, the insurer emphasized its commitment to established merger and acquisition (M&A) criteria and said it “would only consider acquisitions that are strategically aligned, financially attractive, and have a high probability to close.” Cigna also affirmed its stock repurchase activity, noting it has bought back $6 billion worth of stock year to date and will continue into 2025, using proceeds from the pending sale of its Medicare Advantage (MA) business to Health Care Service Corp., which is expected to close in the first quarter of 2025.

With Donald Trump declared the winner of the 2024 presidential election and Republicans controlling at least one chamber of Congress, experts are divided about the myriad ways in which the new balance of power in Washington might affect health insurers. Yet they largely agree on one subject: The Biden administration’s intense scrutiny of health care deals likely won’t be shared by the second Trump regime. 

“The biggest thing is a more permissive antitrust regime, where mergers & acquisitions are going to be allowed,” says Dan Mendelson, CEO of Morgan Health, founder of the consultancy Avalere Health and a former health official in the Clinton administration.  

As legislation to address it languishes in the lame-duck Congress, prior authorization (PA) remains under intense scrutiny. Adding to previous accounts of provider and consumer frustration with PA, two recent reports — one from the Senate and one from ProPublica — offer new evidence of insurers and their contractors denying PA requests to cut costs.  

Physicians have long been wearied of PA battles, noting it negatively affects patient care and contributes to burnout. The continued scrutiny raises the question: What lies ahead for PA reform, especially as the U.S. transitions to a new presidential administration?