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If you’re surprised Elevance Health is having trouble buying a not-for-profit Blues plan, you haven’t been paying attention. The insurance behemoth hasn’t pulled off such a deal in almost 20 years.

Elevance’s announcement that it’s pausing its $2.5 billion bid to buy Blue Cross and Blue Shield of Louisiana follows strong pushback amid concerns about higher prices, fairness to members, and uncertainty over what would happen with the billions in proceeds. Lawmakers in August urged Blue Cross to put the deal on ice, and last week, Louisiana’s attorney general hinted at legal action if the company didn’t do so.

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The last time Elevance successfully brought a Blues plan under its giant investor-owned wing was in late 2005, when it acquired New York City-based WellChoice. Three other attempts by the country’s second largest insurer were thwarted by state regulators, public backlash, and lawsuits. Two other Blues plans failed in their attempts to convert to for-profit companies on their own.

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