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Understanding the Blue Cross and Blue Shield System

At the Blue Cross Blue Shield Association (BCBSA), we believe everyone should have access to health care, no matter who you are, where you live or what your health status may be. We stand willing and ready to continue this work alongside you.

From historical information to up-to-date data and in-depth policy analysis, we have resources to help you better understand health insurance, health care policy and how we can work together to expand coverage, lower costs and build a more equitable health care system for all.

Learn more about how the Blue Cross and Blue Shield (BCBS) System has shaped U.S. health care. 

BCBSA is a national association of 34 independent, locally operated BCBS companies which collectively cover more than 109 million members in all 50 states, Washington, D.C., and Puerto Rico.

The BCBS Commitment to Fighting COVID-19

Since the start of this unprecedented pandemic, BCBSA and all 34 BCBS companies moved quickly to support BCBS members, our health care partners and the communities we serve. BCBS companies swiftly eliminated cost-sharing for COVID-19 testing and treatment and have provided millions in premium relief to members and employer customers.

The BCBS System also is providing significant financial support, protective gear and other aid to health systems and physician practices to ensure they have the resources needed to treat patients. And across the nation, BCBS companies have intervened to address the unacceptable racial disparities that have been laid bare during the pandemic, for example, by bringing testing to underserved communities and acting to meet the unique needs of ethnic groups, including Native Americans, who have suffered disproportionately. To date, BCBS companies collectively have committed more than $7 billion to the ongoing fight against COVID-19.










Learn more about the BCBS response to COVID-19 and our recommendations for policymakers:


BCBSA is a national association of 35 independent, community-based and locally operated Blue Cross Blue Shield companies. Our member companies cover people in every ZIP code in every state, insuring one out of every three Americans across all insurance markets. We provide individual and small-group coverage and participate broadly in the Affordable Care Act (ACA) marketplaces, often offering coverage in counties where no other carrier participates. Seventy-six of America’s Fortune 100 companies choose Blue Cross and Blue Shield coverage for their workers, and BCBSA serves 5.7 million federal employees, retirees and their families through the Blue Cross and Blue Shield Association’s Federal Employee Program.® The Blues® also participate across government programs, particularly Medicare Advantage and Medicaid.

Blue Cross and Blue Shield companies provide coverage for 8.9 million people through Medicaid and 3.7 million individuals enrolled in Medicare Advantage.

Understanding the Health Insurance System

With the implementation of the ACA more than a decade ago, the health insurance landscape changed substantially. We have compiled some information highlighting how the current system works and our recommendations for how it can be strengthened.









BCBSA Key Recommendations

BCBSA consistently reviews policy, regulatory proposals and legislation, using the depth and breadth of our experience to provide policymakers with data, issue analysis and recommendations.

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