After 18 months of courtship and court cases, two massive deals that would have reshaped the U.S. health insurance industry have both been declared dead, blocked by judges who said they'd do unacceptable harm to competition in the industry.

Now, the companies are right back where they started. Anthem Inc.'s $48 billion deal to buy Cigna Corp. was blocked by a federal judge late Wednesday, weeks after another judge halted Aetna Inc.'s bid for Humana Inc. Anthem said it will appeal, and Aetna and Humana have said they're still deciding where to appeal.

The question now becomes what the companies will do with the large piles of cash they allocated for the acquisitions, and whether they'll try anew at fresh takeovers under a Trump administration, whose antitrust officials could be more amenable to large consolidations. They could also opt for something more conservative in the face of widespread uncertainty about the future of the U.S. health system. But first, they may be back in court.