Bloomberg Law
March 16, 2021, 7:17 PM

Obamacare Insurers Inflate Claims to Reduce Refunds, Study Says

Sara Hansard
Sara Hansard

Obamacare insurers have short-changed their consumers by hundreds of millions of dollars, according to a study released Tuesday by university researchers.

Fourteen percent of health insurers, particularly publicly traded insurers, are inflating the medical claims they report paying in order to avoid rebates required under the Affordable Care Act, according to a paper to be published in the Accounting Review. The paper is by Andrew Van Buskirk of Ohio State University, Evan Eastman of Florida State University, and David Eckles of the University of Georgia.

Under the ACA, health insurers are required to spend at least 80% of premium revenue ...