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.