Health Insured

The board of Cigna Corp. on Sunday rejected a $47.5 billion bid from Anthem Inc. that was disclosed on Saturday. Aetna Inc. has made an offer for Humana Inc. in recent days. Those deals, if completed, would shrink the current top five insurers to a powerful big three, each with revenue on paper of more than $100 billion. Meantime, the largest player by revenue, UnitedHealth Group Inc., has recently made a takeover approach to Aetna.

Some of the combinations could pose challenges to competition around the country, according to the Journal’s analysis. For instance, an Aetna-Humana tie-up would increase by about 180 the number of U.S. counties where at least 75% of customers for Medicare Advantage plans are in the hands of a single insurer.

Just in time for the Supreme Court ruling that could break the Affordable Care Act as we know it.