Aetna, Kaiser Owe the Most in ACA Risk Adjustment Program

  • Aug 02, 2024

    Participants in the Affordable Care Act risk adjustment program will pay a record $10.3 billion for the 2023 benefit year, according to CMS. CVS Health Corp.’s Aetna is estimated to owe the highest amount, while several not-for-profit Blue Cross Blue Shield plans are slated to receive significant payments.

    The ACA’s risk adjustment program, launched in 2014, transfers funds from insurers that cover lower-risk enrollees to insurers that cover higher-cost and higher-risk populations in the individual and small group health insurance markets.

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