Highmark continues to battle for $600M it lost on Obamacare

Highmark Inc. will continue pressing its claim against the federal government for $600 million in compensation for losses selling Affordable Care Act health insurance between 2014 and 2017, despite appellate court rulings Thursday against two insurers that filed similar claims.

Highmark’s 2-year-old lawsuit against the federal government, which was among a dozen filed by carriers nationwide, was put on hold pending the outcome of appeals filed in similar cases by Moda Health Plan and the Land of Lincoln Mutual Health Insurance Co.

A federal appeals court in Washington, D.C., on Thursday rejected claims by the two carriers for compensation for losses.

Despite the ruling, Highmark spokesman Aaron Billger said the Pittsburgh insurer will continue its lawsuit.

“We have our own case and we continue to pursue our litigation effort against the federal government,” he wrote in an email. “We are confident of the government’s clear and unequivocal statutory, regulatory and contractual obligations to pay the full amount of the risk corridors payments and we are suing to enforce those obligations.”

It was uncertain whether Moda Health Plan or Land of Lincoln Mutual would appeal to the U.S. Supreme Court, where such appeals are “rarely successful,” according to appellate court guidance.

Judge Pauline Newman dissented from the decision, writing that the government depends on its reputation in such agreements to conduct business. The court’s ruling, she wrote, undermines this basic reliability.

In the early years of the Affordable Care Act, insurers were backstopped for losses in selling essential benefit coverage because there was no historic claims data to use as a guide. But when insurers put in their claims, the government

balked.

So far, the U.S. government has refused to pay Highmark and other health insurers the socalled risk corridor bills, which covered the losses from selling a new product.

Stung by losses in the Affordable Care Act market, Highmark claimed it was owed $222 million in 2014, and $590 million in 2016, which was the equivalent of $1.6 million a day.

UnitedHealthcare, Anthem and Humana were among other insurance companies that reported big losses in the government online health insurance market.

Not all insurers sustained such losses. Pittsburgh-based UPMC Health Plan, for example, reported a loss of just $13,607 in the ACA market for 2014.