Risk adjustment transfers totaled $10.8 billion in 2019, with some insurers on the ACA’s exchanges earning substantial payouts, according to new data from the Trump administration.
The Centers for Medicare & Medicaid Services released (PDF) its annual look at the Affordable Care Act’s risk adjustment program, and said that 561 insurers participated in 2019. The $10.8 billion was split evenly between payments made to insurers and payments to CMS to maintain budget neutrality.
The individual market accounted for the largest share of transfers, or about $7.98 billion.
Payments made to some insurers were significant; for example, Blue Shield of California earned more than $1 billion in risk adjustment, with the bulk coming from an $873.8 million payout for its individual market plans.
Blue Cross Blue Shield of Texas earned a payout of nearly $400 million, and Independence Blue Cross raked in about $41 million.