(Bloomberg) -- The market for health insurance in the U.S. is already so highly concentrated that pending tie-ups among four of the country’s largest insurers risk hurting both consumers and doctors, the American Medical Association said.

Anthem Inc.’s proposed takeover of Cigna Corp. and Aetna Inc.’s bid for Humana Inc. would reduce competition among insurers in 154 metropolitan areas, worsening already concentrated markets, the organization said in studies released Tuesday. The mergers could cause premiums to go up and decrease payments to doctors, the AMA said.

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