BCBS vs. Republicans: The debate over the ACA’s reinsurance program

Blue Cross Blue Shield is imploring Congress to protect the reinsurance program, according to The Hill.

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Here are six things to know:

1. Many Republicans have continually referred to the reinsurance program as a “bailout” for insurance companies.

2. The Hill obtained a BCBS company memo, which stated removing the reinsurance payments would result in higher premiums and less coverage options for consumers.

3. The memo also claims the program is not a bailout as it does not include federal funds. Additionally, the payments to each payer are less than they anticipated. BCBS did not comment the memo to The Hill.

4. After payers had more high-risk patients enrolled in coverage, the Obama administration created the reinsurance program to help them offset the losses. Insurance companies pay into the program, which then provides insurers payments each year if they suffered substantial losses.

5. In 2015, almost 500 payers paid into the pool, and almost every payer received some money back from the pool. The pool totaled nearly $1.8 billion.

6. Republicans have pushed forth legislation this year in an attempt to block the payments’ final round. As of now, the government is expected to distribute the money in summer 2017 for this year’s coverage. Those opposing the reinsurance program argue the government was supposed to pay portions of that fund to the Treasury Department as a fee. However, the government has not yet made the payments.

More articles on coding & billing:
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