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Health insurer Anthem Inc. pressed ahead with its pursuit of a $54-billion merger with Cigna Corp. despite a spurned bid and increasing concerns about industry consolidation. Joseph Swedish, Anthem's chief executive, went on the offensive Monday trying to rally support for his takeover offer among Cigna shareholders and put pressure on the company's board, which rejected his $184-a-share offer over the weekend. He also took on critics of health insurance consolidation who fear it will lead to higher premiums and less choice. (Terhune, 6/22)

Cigna is apparently playing pretty hard to get. Anthem should be careful in how it goes about trying to seal a deal. Anthem, the second largest U.S. health insurer by membership, proposed to buy Cigna, the nation’s fourth-largest, for more than $47 billion. Cigna rejected the overture on Sunday. Anthem, though, is evidently determined. (Grant, 6/22)

Anthem sees its more than $47 billion bid to buy rival Cigna as a way to muscle up on technology that helps consumers and to strengthen its rapidly growing Medicare Advantage business. Leaders of the Blue Cross-Blue Shield insurer reaffirmed on Monday their commitment to getting a deal done a day after Cigna shot down the idea in a letter delivered to Anthem's board. (Murphy, 6/22)

U.S. health insurer Anthem Inc on Monday dismissed concerns that buying smaller competitor Cigna Corp would be considered anti-competitive, even as antitrust experts said the combination would earn regulatory scrutiny. Any merger could require asset sales and would be complicated by potential deals among other insurers, which after years of change due to President Barack Obama's healthcare reform are now scrambling to tie up. (Humer and Bartz, 6/22)

Health insurance giant Anthem (ANTM) on Monday reiterated support for its $47.4 billion cash and stock takeover bid for Cigna (CI), undeterred by the smaller rival's rejection of the latest offer. Indianapolis-based Anthem also tried to build Cigna shareholder support for the proposed transaction, webcasting a conference call with Wall Street analysts to discuss the deal terms. (McCoy, 6/22)

Humana Inc. shareholders have the most to lose if the health insurer gets spit out of the tide of consolidation sweeping the industry. Speculated as the likeliest target among the top five U.S. managed-care providers, Humana could be left to fend for itself -- or forced to take a lower offer than it might like -- if potential suitors merge with each other instead. Anthem Inc. had weighed a bid for Humana, but on Saturday announced a $47 billion proposal for Cigna Corp. While Cigna rejected the $184-a-share cash and stock offer, Anthem reiterated it on Monday. (Sutherland, 6/22)

The average consumer should catch a price break if major health insurers like Anthem and Cigna combine and cut their expenses. That’s the basic theory, at least. The reality will be much murkier for the more than 50 million people who may be affected if Anthem Inc. succeeds with its bid to buy smaller rival Cigna Corp. or if other major insurers combine as many on Wall Street anticipate. (Murphy, 6/22)

Some doctors are nervous about the mergers leading to just a handful of powerful health insurance companies. The American Academy of Family Physicians has already reached out to the Federal Trade Commission to express concerns. In a letter to FTC chairwoman Edith Ramirez, the AAFP wrote that "mergers in the health insurance industry would have an immediate and profound negative impact on the availability and affordability of health insurance for millions of consumers." The organization's chief worry? Bigger insurers will have more clout. They could raise premiums and reduce the number of doctors and hospitals that are part of network coverage plans. (LaMonica, 6/22)

The nation’s largest health insurance company is leaving America’s Health Insurance Plans, the industry’s powerful trade organization. UnitedHealth Group will leave AHIP at the end of the month, the company told POLITICO on Monday. (Haberkorn, 6/22)