Both the American Medical Association and the Maine Medical Association had opposed the proposed merger since it was announced and both had worked with the Justice Department to build a case against it. MMA lawyers had met with the Justice Department back in January of 2016 and expressed concern about the impact of the merger on Maine physicians and their patients. The AMA submitted an amicus brief to the appellate court in support of preserving the merger injunction issued in February of this year.  Based on existing policy established by the AMA House of Delegates, the AMA advocated in 2016 that the Department of Justice block the two proposed mergers between health insurers Aetna and Humana and Anthem and Cigna.

The ruling is the result of 21 months of advocacy by the AMA and the coalition of physician organizations, including MMA, before the DOJ, congressional leaders, state attorneys general, insurance commissioners, and federal court. Barring an appeal to the U.S. Supreme Court, the decision last week concludes a successful campaign by the AMA and 17 state medical associations - on behalf of patients and physicians - to stop the Anthem-Cigna merger.