N.C. Blues: Feds’ risk-corridor case is ‘revisionist history’

Blue Cross and Blue Shield of North Carolina contends the federal government is trying to dodge hundreds of millions of dollars in overdue risk-corridor payments through “revisionist history.”

The U.S. Justice Department recently said the insurer’s lawsuit and several others over the controversial three-year program are premature, since payments allegedly won’t be due until next year at the earliest. But the North Carolina Blues said that argument runs afoul of the Affordable Care Act and the history of the risk-corridor program.

The North Carolina Blues alone is owed $147.5 million in overdue payments for the losses it incurred on the ACA exchange. So far, the feds have paid the insurer only $18 million.

The North Carolina Blues said the risk-corridor program was a big factor in the insurer joining the insurance exchange in the state, as it hedged the financial impact of insuring new customers without necessary medical or actuarial data to help set premium rates. The federal government repeatedly touted the program over the years as a means to protect qualified health plans.

But recently, the Justice Department said the risk-corridor plan was meant to be budgetneutral, a claim the North Carolina Blues vehemently disputes. The insurer pointed out that the final rulemaking establishing the risk-corridor program clearly stated the program was not going to be budget-neutral, and the government’s recent arguments “at best, engage in revisionist history based on post hoc characterizations.”