July 21, 2016, San Francisco, CA– Earlier today, the U.S. Department of Justice filed lawsuits to block
Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana. Eleven states, including
California, joined the Department of Justice’s challenge of Anthem acquiring Cigna. Eight states joined the
challenge of Aetna’s acquisition of Humana. California Insurance Commissioner Dave Jones had previously
urged the Department of Justice to block both mergers, citing concerns about the mergers negatively impacting
access, quality, and cost of care for California consumers. California Senator Dianne Feinstein joined six other
senators in urging the Department of Justice to block the mergers.
In response to the lawsuits announced earlier today, California Reinvestment Coalition Associate Director
Kevin Stein released this statement:
“The California Reinvestment Coalition applauds the actions of the US Department of Justice as well as
California Attorney General Kamala Harris in moving to block these mega mergers that would be harmful for
California consumers. In addition to the many concerns raised about the proposed mergers reducing competition
and harming quality, access, and costs of health care, we also reviewed the track records of these companies
investing in California communities, and we were greatly disappointed.

Despite receiving billions in premiums every year from California consumers, these insurers made only minimal
community investments, especially through the California Organized Investment Network (COIN) program. By
reinvesting more of their premiums in COIN, insurers could have had positive impacts in their communities, for
example, by helping to address our state’s affordable housing crisis, which also has direct impacts on people’s
health. Stronger investments in COIN also could have also helped address racial health disparities and
improving access to healthcare in rural communities. California consumers and communities deserve better, and
we appreciate the Department of Justice, Attorney General Harris, California Insurance Commissioner Dave
Jones, and Senator Feinstein standing up for Californians to ensure that these mergers don’t negatively impact
access, quality, or costs of health care for Californians.”
Additional Background
COIN Program was developed at request of insurers, who now largely ignore it
In 1996, the COIN program was developed at the request of the insurance industry, as an alternative to a
Community Reinvestment Act type community investment requirement for insurance companies. Through
COIN, insurers can invest their premiums in affordable housing and other efforts that support economic and
community development in California’s underserved communities.
However, according to COIN data analyzed by CRC, the insurers who are proposing to merge have largely
ignored COIN. For example, Aetna, Humana, Cigna, and Anthem insurance companies all reported ZERO
participation in the COIN Community Development Finance Institution (CDFI) Tax Credit Investment Program
for every year from 1997 to 2012 and only minimal investments in other COIN programs as compared to the
billions in premiums the companies have collected.
Health Care Mergers Should Include Community Benefit Plans
We believe state regulators and the Dept of Justice should require that all pending and future health care mergers
include community benefit plans that include specific provisions on how the insurers will improve health care
outcomes via community investments. As an example, in the recent merger of Centene and Healthnet, the
merger approval by California Insurance Commissioner Dave Jones was conditioned on the companies making
an investment of $30 million in community investments via the California Organized Investment Network
(COIN) program.
The plans should be:
1) Multi-year, long-term commitments to investing in health services, affordable housing, jobs and economic
development in California communities, that also lower health care costs for consumers and increase access to
higher quality health services.
2) Transparent and publicly available; and
3) Commensurate with the larger size of the companies after the size of the acquisition or merger.