The proposed $48 billion merger between insurance giants Anthem and Cigna looks like it’s dead, as does the $37 billion deal between Aetna and Humana, though Aetna said it will appeal. In both cases, federal judges ruled the mergers would hurt consumers, eliminating competition and driving up prices.

So what now for four of the nation’s five largest health insurers? These companies have billions on hand, and they’ve got to do something with it.

But with the uncertainty over unwinding Obamacare in Washington, figuring out how to spend that money won’t be easy. 

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