Anthem’s $48 billion deal to buy Cigna was blocked by a federal judge, putting an end to the second of two massive mergers that would have reshaped the U.S. health-care landscape.

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Anthem’s $48 billion deal to buy Cigna was blocked by a federal judge, putting an end to the second of two massive mergers that would have reshaped the U.S. health-care landscape.

The transaction violates antitrust laws by reducing competition among insurers, U.S. District Judge Amy Berman Jackson in Washington, D.C., ruled Wednesday. With the deal defeated, Anthem owes Cigna a $1.85 billion breakup fee under the terms of the agreement they reached in July 2015.

The deal, along with Aetna’s proposed tie-up with Humana, which was blocked last month, would have reduced the ranks of big U.S. health insurers to three from five and made Anthem the largest by membership.

While the Aetna-Humana case primarily focused on the market for private health insurance plans for the elderly, known as Medicare Advantage, the Anthem-Cigna case largely turned on the market for health plans sold to employers. In her ruling, the judge looked at its likely effect on the sale of health insurance to “national accounts” — customers with more than 5,000 employees, usually spread over at least two states — within the 14 states where Anthem operates as the Blue Cross Blue Shield licensee.

“Eliminating this competition from the marketplace would diminish the opportunity for the firms’ ideas to be tested and refined, when this is just the sort of innovation the antitrust rules are supposed to foster,” Berman Jackson said in her 12-page order. The judge’s accompanying opinion fully detailing her reasons for ruling against the deal was filed under seal.

Spokesmen for Cigna, Anthem and the Justice Department didn’t immediately respond to requests for comment on the decision.

Analysts had long doubted that the Anthem-Cigna deal could pass antitrust scrutiny, and Cigna’s stock had been trading far below Anthem’s cash-and-stock offer.

Now, all four companies face a more challenging landscape than they did when they reached their deals just weeks apart in 2015. The Affordable Care Act, which expanded the market for Medicaid health plans and for coverage sold to individuals, is under threat as President Trump and Republicans in Congress are moving to replace the law. While the law hasn’t been a big driver of growth for any of the firms, its demise could cut off a source of growth as they try to expand.

The rejections leave the companies with capital that they still want to put to work, raising the prospect of another round of deal-making.

The Anthem-Cigna deal’s failure gives Cigna CEO David Cordani a new chance to shape his company’s path. He has estimated that Cigna would have $7 billion to $14 billion of deployable capital by mid-2017 if the purchase wasn’t completed. The high end of that range includes extra debt the company could take on if it decided to make acquisitions, Cordani has said. The funds could also be used to pay dividends and buy back stock.

“We have a track record of being very disciplined relative to our capital priorities and not allowing surplus capital to sit around,” he said on Jan. 11.

Anthem has also said it would pursue deals and buybacks if the Cigna transaction didn’t go through. CEO Joseph Swedish has said he might attempt to expand in the Medicare Advantage market through acquisitions.