American health insurer Centene has announced that the insurance departments of Arizona, Georgia, Connecticut, Ohio and Texas have approved the proposed $17.3bn takeover of WellCare Health Plans.

The agreement, which was signed in March this year, has secured regulatory approvals in 24 states in the US.

For each share of WellCare common stock, its shareholders will receive a fixed exchange ratio of 3.38 shares of Centene common stock and $120 in cash.

Upon completion of the deal, Centene shareholders will own approximately 71% of the combined entity, while WellCare shareholders will hold the remaining 29% stake.

Additionally, both the companies will create a premier healthcare enterprise focused on government-sponsored healthcare programmes.

The combined enterprise will serve nearly 22 million members across all 50 states in the US. The estimated pro forma revenues of the combined companies would be nearly $97bn in 2019.

Centene chairman, president and CEO Michael Neidorff said: “We are making important progress in our merger process and are pleased that state insurance regulators continue to see the benefits that our combination will bring to recipients and communities.

“We will continue to work with the remaining state insurance regulators to demonstrate how we will provide recipients with access to affordable, high-quality services and products as well as deliver fair compensation for providers and create savings for states.”

Centene will fund cash portion of the transaction using debt financing for which the British lender Barclays has agreed to provide an $8.35bn financing.

The companies believe that the deal will be concluded by the first half of the next year.