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U.S. insurance regulators and state attorneys general are lining up to scrutinize Aetna Inc's proposed $33 billion takeover of rival Humana Inc for potential harm to consumers, complicating what is already expected to be a tough and lengthy review by federal antitrust authorities. Insurance commissioners in 18 states including Texas, Kentucky and Florida will study merger documents provided by Humana to determine whether the deal will harm competition and lead to higher insurance premiums or diminished access to healthcare providers, according to Reuters interviews with regulators and insurance experts. (Humer, Bartz and Freifeld, 7/10)

A proposed merger between two health insurance giants is drawing concerns around the country and in Missouri, as some fear the consolidation could leave older adults in the state with fewer choices for health care. Earlier this month, Aetna Inc. announced it would acquire Humana Inc. for about $37 billion, a combination that would produce the nation’s second-largest health insurer, just behind UnitedHealth Group Inc. (Shapiro, 7/11)

An acquisition by Aetna would bring an end to the half-century of radical company makeovers by Humana and create an insurance giant in the fast-growing market for government-subsidized health plans. Louisville, Ky.-based Humana—a $23 billion company that began as a single nursing home in 1961 founded by David Jones and Wendell Cherry—is the second-largest player in Medicare Advantage, Medicare's private managed-care option that has seen enrollment triple in the past decade. That program will continue to grow, with a surge of baby boomers entering Medicare. (Evans, 7/11)

With 7,800 retail stores and a presence in almost every state, CVS Health has enormous reach. And while shoppers might think of CVS as a place to pick up toothpaste, Band-Aids or lipstick, it is also the country’s biggest operator of health clinics, the largest dispenser of prescription drugs and the second-largest pharmacy benefits manager. With close to $140 billion in revenue last year — about 97 percent of that from prescription drugs or pharmacy services — CVS is arguably the country’s biggest health care company, bigger than the drug makers and wholesalers, and bigger than the insurers. (Tabuchi, 7/11)