Blue Cross begins airing own ads to counter attacks amidst Jackson Hospital struggles

MONTGOMERY, Ala. – This week’s Sunday Night Football broadcast on NBC featured one of the season’s most competitive, high-flying matchups between the San Francisco 49ers and the Chicago Bears.

But viewers in Alabama were witness to a different kind of air war during the commercial breaks, as multiple rounds of ads attacking Blue Cross and Blue Shield of Alabama aired during the primetime game, only to be countered by ads from the insurer itself refuting the claims.

A 30-second attack, paid for by a mysterious group called Alabama Patients First, alleges that Blue Cross denies claims more than any other insurer in the country while pocketing profits.

“They’ve made a killing off of telling you no,” the ad says. “… That’s Blue Cross bull(bleep).”

The Alabama Patients First ad began airing earlier this month, as first reported by YellowHammer News and 1819. The attacks began soon after Jackson Hospital in Montgomery filed a lawsuit against the state’s largest insurer. The suit is part of the financially struggling hospital’s ongoing bankruptcy proceedings. It has warned city, county and state leaders for more than a year it is at risk of closure.

Alabama Patients First is a limited liability company registered on Dec. 11 in Delaware. According to online records, the registering agent is The Corporation Trust Company, a company that offers registering services, based in Wilmington. Details about the entity’s financial backing is unknown.

The ad appears to be scheduled to run well into January with as much as $300,000 behind it, according to an ad buying analysis obtained by ADN . While that ad doesn’t specifically mention Jackson Hospital, it coincides with the ongoing legal process as well as the Alabama Legislature’s 2026 session in Montgomery beginning Jan. 13.

Another attack ad circulating online and via text, says BCBS is “ripping off Jackson Hospital” by paying it lesser rates than other hospitals.

Sunday, BCBS began airing its own ads in the Montgomery market with plans to expand their distribution.

They say the insurer spends about 90% of its premiums on patient care and approves 95% of claims.

“Your hard-earned money spent on your care,” an ad says.

Another says an anonymous, out-of-state group is lying about the insurer.

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The hospital filed for bankruptcy in February of this year and continues to operate through a $25 million debtor-in-possession loan from Jackson Investment Group, the parent company of Georgia-based Jackson Healthcare. Unrelated to the Montgomery hospital, Jackson Healthcare provides health care workforce services, according to its website.

Attempts Tuesday by Alabama Daily News to reach the hospital and Jackson Healthcare and Jackson Investment Group about the ads were not successful.

In its filings, Jackson Hospital said that in 2023 alone, it provided $45 million in care to uninsured patients.

In September 2024, Jackson Hospital saw its bond rating lowered to a “D” after it had defaulted bond interest payments, resulting in the hospital’s CEO and COO stepping down from their positions.

In a Dec. 18 court filing, Jackson Hospital blamed BCBS for at least some of its financial woes.

“Blue Cross Alabama calls itself a ‘nonprofit,’ but the insurance giant has become one of the most powerful and profitable corporations in Alabama – sitting on billions in reserves, paying executives multi-million-dollar salaries/bonuses, and posting hundreds of millions in annual surpluses while hospitals across Alabama (like Jackson Hospital) struggle to stay open and patients go without critical care,” the filing said. “There is no doubt – Blue Cross Alabama places profits above patient care, as evidenced by Blue Cross Alabama recently boasting the highest Affordable Care Act claim denial rate in the country…”

A spokesperson for BCBS said the company was limited in what it could say due to the ongoing litigation. But in a statement, the insurer said it has negotiated with Jackson Hospital in good faith and has repeatedly increased Jackson Hospital’s reimbursement rates in recognition of its financial difficulties.

“Jackson Hospital is more than fairly compensated by Blue Cross for the services it offers,” the insurer said. “Although Blue Cross customers make up only 25% of the patients that Jackson Hospital treats, Jackson Hospital’s Texas lawyers seek Blue Cross customers to pay for the hospital’s mismanagement.

“Contrary to the misinformation contained in the complaint, Blue Cross and Blue Shield of Alabama is a tax-paying not- for- profit health plan. It is – and has been for many decades – one of the most efficient health insurance companies in the country paying out more than 90% of every premium dollar to hospitals and other healthcare providers. Our personnel costs – salaries and all benefits for our more than 3,000 Alabama-based employees – are less than 4% of our revenue. In the past five years Blue Cross has paid more than $400 million in taxes into the Alabama General Fund.”

The Montgomery City Council recently passed a resolution to offer financial support to Jackson Hospital, though the measure was then vetoed by Mayor Steven Reed who argued the county had the prevailing responsibility to offer support. The Montgomery County Commission has so far declined to pass any kind of financial bailout.

In its complaint against Blue Cross, the hospital said its closure “would be far-reaching and devastating.”

“…Approximately 1,800 employees would be displaced; the Montgomery region already does not have enough hospital beds to serve those in need of acute medical care; and wait times at surrounding emergency rooms would increase exponentially.

“Put simply, if Jackson Hospital closes, there would not be nearly enough medical care to treat Alabamians in need.”

This story is from alabamadailynews.com.