The Virginia Hospital & Healthcare Association and a coalition of national and state consumer organizations and unions have raised concerns about the proposed Anthem-Cigna and Aetna-Humana mergers and health insurance consolidation in general. “There exists the very real potential for the transactions to substantially reduce competition, increase the costs of premiums and diminish the insurers’ willingness to be innovative partners with providers and consumers in transforming care,” VHHA’s letter to Commissioner of Insurance Jacqueline Cunningham states, specifically pointing out that the acquiring companies in both proposed mergers stand to gain significant market share in the state. “Consequently, Virginia’s hospitals and health systems strongly encourage the Bureau of Insurance to...diligently review the proposed mergers.” In separately submitted comments, the 10-organization consumer-union coalition says, “Our organizations are troubled by the consolidation within the health industry and its impact on price, access and quality of care. Mergers between four of the five dominant insurers could further harm competition in the Commonwealth of Virginia. Although the merging companies are claiming various supposed benefits associated with these mergers, all scholarly evidence suggests that consumers will see limited to no benefits and instead will face higher costs, less innovation and potentially lower quality of care.”