Missouri Insurers Rake In Millions For Taking On High-Cost Clients

July 01--Missouri health insurance companies received more than $100 million to help ease the transition to complying with the Affordable Care Act, according to a report released Tuesday.

Under the program, created by the health law, all insurance companies across the country pay into a pool and then insurers who sell individual policies receive money back if they had high expenses as part of the transition. Nationally, insurers will receive about $8 billion for 2014 health coverage, according to the federal report.

In Missouri, Coventry Health Care was the largest recipient, collecting $76 million. Anthem BlueCross BlueShield took in about $32 million. This cost-sharing program will run for two more years.

But the two companies had to fork over millions to other insurers through a separate Affordable Care Act program, according to the report. That program requires companies to reimburse insurers who take on a disproportionate share of customers with high-cost, chronic medical conditions.

Under that risk adjustment program, Coventry owed about $15 million, while Anthem had to pay about $5 million. The largest recipient of those dollars was BlueCross BlueShield of Kansas City, a nonprofit insurer, which received about $18 million.

The Affordable Care Act prohibits insurance companies from charging higher premiums to customers with pre-existing medical conditions. To ease that transition, the law instituted reimbursement programs to help insurers cope.

Jordan Shapiro -- 314-340-8114

@jordanshapiro13 on Twitter

jshapiro@post-dispatch.com

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