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			 The formation of a large group to scrutinize Aetna Inc's plan to buy 
			Humana Inc and Anthem Inc's bid for Cigna Corp complicate what is 
			already expected to be a tough and lengthy review by federal 
			antitrust enforcers. 
			 
			Connecticut, Florida, Iowa, Massachusetts and Tennessee are among 
			the states that have joined forces to investigate the proposed 
			deals, according to sources close to the states, who spoke to 
			Reuters over recent days. Antitrust probes are designed to determine 
			if a merger would lead to higher prices or otherwise hurt consumers. 
			 
			The other states participating in the roughly 15-member group could 
			not be learned. The sources asked not to be named because the 
			investigation is not public. 
			 
			The presence of a large number of attorneys general joining a 
			Justice Department probe underscores the hurdles that both proposed 
			combinations face in winning U.S. regulatory clearance. 
			  
			
			  
			 
			Democratic presidential candidate Hillary Clinton, several lawmakers 
			and the American Medical Association, a leading physicians group, 
			have said they feared the pending acquisitions would hurt consumers 
			by leading to higher insurance premiums or limited access to 
			healthcare providers. 
			 
			While it is up to the Justice Department to ultimately decide 
			whether to file a lawsuit to stop a merger, states provide data to 
			the department on how the mergers would affect their jurisdictions 
			and conduct joint calls to gather data from the companies, as well 
			as critics and supporters of the deals. 
			 
			One of the most controversial deals last year, the proposed 
			acquisition of Time Warner Cable by Comcast, attracted about two 
			dozen state attorneys general who joined the federal antitrust 
			review. Comcast abandoned the plan in the face of regulatory 
			opposition. 
			 
			The chief executive of Anthem, Joseph Swedish, said in an interview 
			that the decision of the state attorneys general to join with the 
			Justice Department was “a good thing.” 
			 
			“The states created this path with the DOJ (Justice Department) to 
			promote education, engagement. They develop a lot of insights so 
			that when the DOJ does rule, our work with all of these states is 
			probably enhanced quite a bit because we are not starting from 
			scratch,” he said. 
			 
			Aetna, separately, voiced confidence in the process. "We are 
			confident that our transaction will receive a fair, thorough and 
			fact-based review from the Department of Justice and the states," it 
			said in a statement. 
			
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			Humana declined to comment, while Cigna did not immediately respond 
			to a request for comment. 
			 
			Anthem announced in July it would buy Cigna for about $54.2 billion 
			to create the largest U.S. health insurer by membership. The 
			announcement came weeks after Aetna struck a $37 billion agreement 
			to buy Humana. 
			 
			Healthcare insurers say that becoming bigger will allow them to 
			squeeze out administrative costs, negotiate with doctors and 
			hospitals and push down the soaring costs of some drugs. 
			But the American Medical Association estimates that 41 percent of 
			U.S. metropolitan areas already have a single health insurer with a 
			commercial market share of 50 percent or more. It believes the 
			decrease of nationwide health insurers to three from five would make 
			more regions anticompetitive. 
			 
			The American Antitrust Institute, in a letter to the Justice 
			Department on Monday, said the deals would "substantially lessen 
			competition in numerous health insurance markets." 
			 
			"The AAI recommends that the DOJ 'just say no' to the two deals that 
			would fundamentally restructure the nation’s health insurance 
			markets and create further incentives for 'reactive' consolidation 
			in the healthcare supply chain," the group said in the letter. 
			
			  
			(This version of the story has been refiled to correct to "said in 
			an interview," not a phone interview, in ninth paragraph) 
			 
			(Reporting by Diane Bartz; Additional reporting by Caroline Humer; 
			Editing by Soyoung Kim and Leslie Adler) 
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