Insurers Suing Federal Government Over Risk Corridors Debts

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Blue Cross and Blue Shield of North Carolina is filing a lawsuit against the federal government – yet another insurer that Obamacare apparently owes money to.

The insurance company filed the lawsuit Thursday, demanding $129 million in unpaid risk corridor payments. They claim the government has paid less than 10% of the risk corridor payments they should have been paid from 2014.

The risk corridors program is designed to provide a cushion against sharply increasing costs for insurance providers caused by high claims costs of newly insured clients.

The program was designed to limit insurance providers that offer qualified health plan losses by giving funding to companies facing high claim costs from its clients, but a larger number of claims than what both the government and insurers expected as substantially driven up the costs. Insurance providers sought over $2 billion in 2014 in total risk corridor payments, but the Department of Health and Human Services (HHS) only paid $362 million.

BCBSNC is also seeking for assurance from the government that risk corridors for 2015 and 2016 will be paid on time. The company provides insurance coverage to 3.89 million North Carolina residents, about a third of the state’s population.

This suit is just the latest in a series of lawsuits filed by health insurance providers against HHS. This lawsuit comes a day after Moda Health of Portland, Oregon, demanded $180 million in risk corridor payments.

Nonprofit health insurance provider Highmark Inc. filed a lawsuit Tuesday claiming around $223 million from the federal government, also due to Obamacare’s risk corridors program. The insurance provider, based in Pittsburgh, Pennsylvania, plays a huge role in the Pennsylvania, West Virginia and Delaware markets. The company said that by not paying what they owe, the government is in violation of the Fifth Amendment because it is not providing Highmark with the “just compensation” agreed upon and is determined to get its due.


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