A Florida judge has rejected Oscar Health’s request for an injunction that would block Florida Blue from reaching exclusive agreements with insurance brokers.
Oscar filed suit against Blue Cross Blue Shield of Florida in November, alleging that the insurer engaged in anticompetitive practices by monopolizing these brokers and preventing Oscar from growing its exchange business in the state. Its injunction request followed shortly thereafter.
However, in the ruling (PDF), Paul Byron, a judge for the Middle District of Florida, said that Oscar failed to prove that actions taken by Florida Blue caused “irreparable harm” to its business.
“The Court is unpersuaded by Oscar’s argument that Florida Blue’s exclusivity policy is responsible for the market share obtained in Orlando in the first year of competition,” Byron wrote.
In its request, Oscar argued that Florida Blue’s dealings led directly to its failure to sell enough plans in Orlando, and that the agreements with brokers have also prevented it from expanding in Jacksonville and Tampa. An economist providing testimony in the case noted that the Blues plan holds a 91% market share in Orlando.
That wasn’t enough to sway Byron on the injunction, however. For one, the judge ruled, Florida Blue offers a larger slate of plans in the state’s Affordable Care Act exchanges—including some plans without deductibles—and has broader provider networks, which could grow its market share.
In addition, Byron said, another exchange competitor, Centene Corporation, has also carved out a notable market share in Florida, which indicates the current market is competitive. Centene’s enrollment has grown from about 8,300 members in 2014 to more than 371,000 members in 2018, the judge said.
Following Byron’s denial of the injunction, Florida Blue filed a motion (PDF) to have the case fully dismissed.
“We believe that we presented compelling evidence to the court, and are pleased that Judge Byron found in Florida Blue’s favor,” the insurer said in a statement.
In a statement, Oscar General Counsel Bruce Gottlieb said the insurer was “disappointed” by the decision.
“We look forward to further pursuing our claims on the merits,” Gottlieb said.