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Jacquelyn Martin/AP

The Aetna-Humana merger is all but dead after a judge said the deal would ruin competition, especially in Medicare Advantage.

But the ruling shed some damning light on how the Obamacare marketplaces factored into the deal, and how Aetna executives wanted to use their participation and withdrawals from the marketplaces to help gain approval for their deal.

Here are some of the most controversial Obamacare portions of the Aetna-Humana ruling.

  • Aetna CEO Mark Bertolini had been optimistic about Obamacare's insurance exchanges but decided to bail on most markets last year after suffering losses. The ruling showed he viewed Aetna's exits as a way to gain leverage in its litigation against the Department of Justice.
"Bertolini believed that DOJ should not block the merger in view of Aetna's role in advancing the ACA and participating in the exchanges, and Aetna was willing to offer to expand its participation in the exchanges if DOJ did not block the merger, or conversely, was willing to threaten to limit its participation in the exchanges if DOJ did."
  • Steven Kelmar, Bertolini's chief of staff, put the heat on Health and Human Services Secretary Sylvia Mathews Burwell before the Department of Justice intervened.
Kelmar told Secretary Burwell that if the merger was blocked, Aetna "would likely have to revisit its plans for and presence on the public exchanges."
  • In one email, Bertolini expressed anger at the Obama administration's decision to block the Humana deal even though he had publicly supported the exchanges.
"The administration has a very short memory, absolutely no loyalty and a very thin skin."
  • There was a concerted effort from Aetna executives to conduct conversations over the phone or in person to keep them out of court review. But some emails were found through the discovery process, including those from Christopher Ciano, the president of Aetna's Florida market. Ciano was perplexed Aetna was leaving his state's Obamacare exchange even though Aetna was making a profit.
"Really disappointed we are pulling the plug on Florida." Ciano followed up with "I just can't make sense out of the Florida decision...Never thought we would pull the plug all together. Based on the latest run rate data...we are making money from the on-exchange business. Was Florida's performance ever debated?" [Jonathan Mayhew, head of Aetna's exchange business] responded with a request to discuss via phone "instead of email." As Mayhew explained in court, these requests for phone calls were an attempt to avoid leaving a paper trail.

The full 158-page ruling from Judge John Bates can be viewed here.

Go deeper

Most teachers are white. Most students aren't.

Expand chart
Data: U.S. Department of Education, National Center for Education Statistics; Chart: Baidi Wang/Axios

The nation's 6.6 million teacher workforce has grown more racially and ethnically diverse over the past three decades — but not nearly fast enough to keep pace with a student population that's nearing majority-minority in public schools, two new reports show.

Why it matters: The disparities are especially acute between Hispanic students and teachers, and in schools with 90% or higher non-white student populations.

Updated 11 hours ago - World

UK government: Kremlin has plan "to install pro-Russian leadership" in Ukraine

British Foreign Secretary Elizabeth Truss. Photo: Gints Ivuskans / AFP via Getty Images

The United Kingdom's Foreign Secretary on Saturday night said the government has "information that indicates the Russian Government is looking to install a pro-Russian leader in Kyiv as it considers whether to invade and occupy Ukraine."

Driving the news: U.S. National Security Council spokeswoman Emily Horne called the intelligence "deeply concerning" in a statement to Axios. The Biden administration has said Russia is actively manufacturing a pretext for invasion and warned that Putin could use joint military exercises in Belarus as cover to invade from the north.

Updated 13 hours ago - Science

This powerful new accelerator looks for keys to the center of atoms

Illustration: Eniola Odetunde/Axios

Nuclear physicists trying to piece together how atoms are built are about to get a powerful new tool.

Why it matters: When the Facility for Rare Isotope Beams begins experiments later this spring, physicists from around the world will use the particle accelerator to better understand the inner workings of atoms that make up all the matter that can be seen in the universe.