How Anthem may win by sitting out healthcare’s merger mania

Four of the five major health insurers in the U.S. are involved in major mergers and acquisitions discussed over the past few months. The lone exception has been Anthem, which may put the company in a stronger position, according to the Wall Street Journal.

While Humana is talking with Walmart, Aetna is waiting to be bought by CVS Health, Cigna Is looking to buy Express Scripts and UnitedHealth has been expanding its provider portfolio, Anthem has been largely silent on any major deals. There’s no guarantee any of these transactions will be completed—just like Anthem’s abandoned merger of Cigna—and investors have been largely on lukewarm on these proposed vertical integrations. Cigna, for example, has seen its stock price fall 13 percent in the past month.

By waiting to see how the dust settles, Anthem has many options available for future growth. WSJ’s Charley Grant noted its net debt sits at roughly 35 percent of total capital, leaving room for expansion on the balance sheet. If it chooses to be more aggressive with acquisitions, it could start by targeting smaller insurers like WellCare, Centene and Molina Healthcare.