The drumbeat of industry consolidation got louder this week as shareholders for health insurers Anthem and Cigna approved a merger. It becomes the second major health care merger to move toward final regulator approval within the past two months.

The first major combination featured Aetna’s purchase of Humana, a deal valued at some $40 billion. Anthem shareholders and board said OK to cutting a check for $54 billion so that Anthem could swallow up Cigna.

Consumer advocacy groups have cautioned regulators that such transactions threaten measures taken to contain health care cost increases, since consolidations can lead to price hikes in areas where one insurer dominates the market. The insurers have insisted such fears are unfounded.

Regulators have not set any dates for announcing their thumbs up/thumbs down on the mergers.