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If the New York State Department of Financial Services has anything to do with it, the planned merger between CVS Health and Aetna Inc. may not be a done deal.

At a public hearing on Oct. 18, the agency's superintendent, Maria Vullo, said she is concerned that CVS, which had to borrow $40 billion to fund the $69 billion deal, could raise insurance premiums for millions of residents.

New York Insurance Law provides that I, as the Superintendent, shall disapprove an acquisition if I determine that such action is reasonably necessary to protect the interests of the People of this State,” Vullo said, according to a published account of her opening statement.

Factors to consider in this determination, Vullo added, are the financial condition of both parties, the source of funds for the acquisition, whether it is likely to harm or prejudice stakeholders and whether the acquisition will harm competition.

In short, the statute provides very broad authority, and my responsibility is to consider the impact on the people of New York State, and to ensure that, were this transaction to proceed, adequate oversight will be obtained so that promises being made by the companies today are kept – in terms of the reduction of costs to consumers and the betterment of health care services to New Yorkers,” Vullo said in her opening statement.

Earlier this month the U.S. Department of Justice announced that it will approve the retail pharmacy giant's purchase of Aetna, one of the country's largest health insurers, assuming the latter divests its Medicare Part D prescription drug plan for businesses for individuals. Regulators in Connecticut, where Aetna is based, also approved the deal earlier this month. It still has to pass through other state regulatory agencies, though.

In addition to her concern about potential premium rate increases, Vullo also expressed worry about increased pharmaceutical costs; data privacy issues; community support, and CVS' ability to do business statewide, “in a manner that serves New York's communities fairly and equitably, including those communities most in need of access to affordable health care services.”

“As part of this proposal, Aetna must commit to maintaining Aetna's products, services networks (without DFS's approval) and that this transaction's proposed savings are actually felt by New Yorkers, including in premium reductions,” she said. “I have already expressed my concerns that Aetna has not participated in the individual market on the New York Exchange.”

Vullo continued: “If the transaction proponents are really serious about their claim to protect New Yorkers in communities across the State, then they will support the Affordable Care Act markets in New York, assist New Yorkers who are uninsured and underinsured, and provide health care service to everyone, not just the rich.”

In addition, during oral testimony during the hearing, Vullo was seeking support from CVS for a proposed state law that would require prescription benefit managers to register with the Financial Services Department, according to a New York Post account of the hearing.

CVS lawyer Elizabeth Ferguson told Vullo during the hearing that the company would not oppose the measure, the Post said.