The American Medical Association (AMA) appreciates the opportunity to provide our views regarding the proposed merger of CVS Health Corporation (CVS), the largest retail pharmacy chain and specialty pharmacy in the United States and one of the two largest pharmacy benefit managers (PBM), and Aetna, Inc. (Aetna) the third largest U.S. health insurer. We commend the California Department of Insurance (the Department) for scrutinizing this massive proposed merger and the potential negative impact it poses to Californian health care consumers.