Though Appeals Persist, Blue Cross Blue Shield Antitrust Settlement May Already Be Having Impact

Although it’s been more than 10 years since antitrust litigation was first filed against Blue Cross Blue Shield plans, an objection to a settlement reached with one group of plaintiffs has delayed the conclusion of a case that carries significant implications for the health insurance industry. Legal and health policy experts say it could be another year or more before the litigation is finalized — but in the meantime, they suggest that the settlement’s rewriting of Blues plan rules is already sparking consolidation in the market.

In the circa-2012 litigation, a group of health insurance subscribers (health plans and employers) and a cohort of health care providers allege that certain long-held Blues plan practices violate federal and state antitrust laws. Those practices include allocating geographic markets through license agreements and limiting the percentage of non-Blue revenue each plan can earn, among others. Although the subscriber class and the defendants reached a tentative settlement in 2020, and an Alabama district court judge approved it in 2022, a small group of employers including the Home Depot filed appeals last fall that effectively put the settlement on hold.

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