It’s a megadeal that is causing everyone involved in the health industry to stand up and take notice: Anthem will buy Cigna for $54 billion, and that will reduce the large insurance companies in the United States down to just three.

The merged company is projected to have around $115 billion in annual revenue and cover about 53.2 million people.

Sluggish growth in traditional employer-paid health care is combining with faster growth in government-sponsored health care such as Medicare or the subsidized plans created by the health care overhaul to make the companies seek mergers.

Both companies operate insurers of various lines in Nebraska. In this case, Anthem Inc. has agreed to purchase Cigna Corp. for $48.4 billion. Dan Mendelson, chief executive of Avalere Health, sees healthcare providers as more likely to seek acquisitions in areas that complement services they already offer, from acute care to physical rehabilitation and skilled nursing facilities. But if they are, health-care facility operators are going to have to contend with bigger, more powerful insurers.

The question of how the mergers will affect card-carrying members is complicated.

Greaney, an expert on health and antitrust law at Saint Louis University said “Economic evidence shows that with fewer competitors, insurance premiums tend to be higher”. Analysts say that because of new caps on the profit that insurers can make on their plans, the companies have been looking to cut administrative costs by increasing their scale. In an interview with the Los Angeles Times last month, Jones said there’s potential for future price increases for consumers because of the decreased competition.

The biggest healthcare insurer in the US will be created by the historic deal, the largest in the sector.

“Market share helps. The larger you are, the stronger standing you have”. Executives said they’re confident they can obtain authorization to close the deal by the second half of 2016.

Anthem, a Blue Cross and Blue Shield insurer, said it would buy all of Cigna’s shares in a cash and stock transaction.

In a joint announcement Friday, the companies said Anthem will pay $188 a share, a 37 percent premium over Cigna’s price at the end of May, before merger rumors surfaced.

Anthem and Cigna are two of just four major insurers that administer self-insured plans for major companies. Anthem specializes in selling individual coverage and insurance to workers of small businesses.

About 15 percent of revenue will come from Medicaid and Medicare members, and Anthem will also be gaining Cigna’s growing global business.

“Our commitment to ensuring that consumers have access to affordable health coverage is the foundation of Anthem’s proposed acquisition of Cigna, and will remain one of our top priorities”.