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The “strategic affiliation” of two health insurers that operate Blue Cross and Blue Shield plans in five states makes it more difficult for Anthem to expand using the valuable Blues brand in new markets.

Cambia Health Solutions and Blue Cross and Blue Shield of North Carolina (Blue Cross NC) said this week the are forming a “strategic affiliation” that merges operations and management of two companies operating Blues plans on the East and West coasts.

That makes it less likely the larger Cambia wants to sell to the publicly-traded, investor-owned Anthem, which i...

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