Blue Cross and Blue Shield of Vermont is about to be swallowed whole by one of its much larger cousins. The deal seems benign and, since it holds out the promise of lower costs for health insurance, it’s virtually certain to go through.

The unintended consequences will come later. As will the intended consequences.

The proposed deal, first announced in May, is on a fast track to approval. The state Department of Financial Regulation set aside a two-week window for public comment, which closes the day after tomorrow. Next week, the DFR will hold a public hearing. After that, approval seems a certainty. The two partners have said they want to finalize the arrangement by October 1.

The deal involves BCBSVT, which I will call “Vermont Blue” for clarity’s sake, becoming “affiliated” with Blue Cross Blue Shield of Michigan, or “Michigan Blue.” And despite the seemingly collegial tone of “affiliation,” it’s a takeover. Like a shark devouring a tasty fish.

Or, to change midstream to a different animal analogy, Michigan Blue is the dog and Vermont Blue will be the tail. Michigan Blue insures more than five million people; Vermont Blue, at 200,000, will effectively be a rounding error on Michigan Blue’s bottom line.

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