But insurance regulators in most states also have a shot at derailing or modifying the deals and will spend the first half of 2016 crunching data and holding public hearings.
The insurers won't be able to merge in states that turn down the proposals. That means rejections from even a few of the most-populous states could break the deals by diluting their financial feasibility.
“A handful of commissioners really could stop it nationwide,” said John Oxendine, a former Georgia insurance commissioner.
Peter Pavarini, immediate past president of the American Health Lawyers Association, agreed that scenario “could be a showstopper.”
Aetna has said it is confident its proposal “will receive a fair, thorough and fact-based review from the Department of Justice and the states.” So far, Michigan, Utah and Vermont have approved it.
Anthem said in a statement that it's having “collaborative and productive conversations” with state leaders.
