Anthem, Cigna shareholders approve Merger as Antitrust Hurdles Await

Shareholders of Anthem (ANTM) and Cigna (CI) approved by overwhelming margins the merger of the two health plans into the nation’s largest health insurance company.

Anthem’s $54 billion purchase of Cigna still needs approval of federal regulators. Groups representing medical care providers like the American Medical Association and the American Hospital Association have already urged the U.S. Justice Department to closely scrutinize the deal.

The Anthem and Cigna marriage comes amid unprecedented consolidation in the healthcare industry and among health plans in particular. This summer, Aetna (AET) announced plans to buy rival Humana (HUM) for nearly $40 billion. And while Aetna and Humana shareholders signed off on that deal less than two months ago, it has yet to be cleared by antitrust regulators either.

Anthem’s acquisition of Cigna would create a behemoth with 53 million health plan members under the combined larger company’s umbrella. Anthem operates Blue Cross and Blue Shield plans in 14 states and would add membership from Cigna in those states but would be forced to market under a different brand outside of those regions because other insurers have the Blue Cross and Blue Shield Association license in other states.