Policy changes and pressures of the marketplace have been driving considerable consolidation in the health care industry. Two proposed mergers involving four of the nation's five largest health insurers-Anthem (Empire) and Cigna, and Aetna and Humana-would have different effects in the various states where these companies operate. This Big Picture snapshot report examines the two merger plans based on the New York footprints of the insurers proposing to merge. It explains the review process by federal and state officials that is currently unfolding, and places the proposed mergers in the context of the Affordable Care Act and a changing health care landscape.

The Next Wave is the second in a series of snapshots highlighting issues related to the Affordable Care Act as a complement to UHF's annual Big Picture chartbook on health plan operations. The first snapshot report, After the Reinsurance Is Gone, looks at the Transitional Reinsurance Program. The third, New Life-and Covered Lives, examines steps New York took to improve its individual market. The fourth, New York's Temporary Premium Subsidies, lays out lessons to be learned from a creative and effective temporary subsidy program. The Big Picture VI, a comprehensive overview of New York's insurance markets, analyzing enrollment and financial data across health plans and lines of business since implementation of the ACA, is available here.

Support for the United Hospital Fund's Health Insurance Project is provided by the New York Community Trust.