Despite threats to the contrary, New York state regulators have approved CVS Health’s proposed acquisition of Aetna Inc., paving the way for the $69 billion deal to close this week. But the merger will cost CVS $40 million paid to the state over three years for health insurance education and require the fulfillment of about a dozen other conditions.

New York State Department of Financial Services superintendent Maria Vullo announced Monday that CVS has agreed that “New Yorkers will not pay to finance this acquisition, in insurance premiums, drug prices or otherwise,” according to the agency’s decision and order approving the deal. During a public hearing in October, Vullo expressed concerns that CVS, which had to borrow $40 billion for the acquisition, could raise insurance premiums for millions of residents.

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