Consumers Are Stuck in the Middle of Highmark/UPMC Stalemate

This past week I participated in a news conference in Harrisburg to discuss legislation that would help preserve access to health care for millions of people in western Pennsylvania. 

This is a direct result of the stalemate that continues between the University of Pittsburgh Medical Center (UPMC) and Highmark. Legislators on both sides of the aisle are urging UPMC and Highmark to break the stalemate and do the right thing for those who rely on the companies for their health care needs. The priority should be on what’s best for the public.

It’s easy to get caught up in the business aspect of the stalemate, but I have not lost sight of the fact that patients are the priority here and it’s not fair that they have to be stuck in the middle. Consumers should have peace of mind of knowing that they will continue to have the same access to the doctors and medical facilities that they have used for years.

Out-of-network costs would be unaffordable to many if a new contract isn’t agreed to. The combined impact of these two companies is substantial—there are more than 20 hospitals and 400 doctors’ offices and outpatient sites under UPMC, and Highmark is one of the largest health insurers in the United States.  Together, they affect three million people in western Pennsylvania.

During last week’s press conference, we discussed legislation that has already been introduced to address the issue. 

House Bill 32 would strengthen the authority of Pennsylvania’s insurance commissioner to get involved in contract disputes between a hospital and insurer. Specifically, the commissioner would have the power to determine whether termination of a contract is in the best interest of the public, and if it is not, to extend the contract for another term. 

Another bill, House Bill 1910, would require binding arbitration between UPMC specialty hospitals and Highmark if they can’t reach a contract agreement on their own. The bill would ensure that special care facilities are not shut off to patients due to the dispute. Both bills remain in the House Insurance Committee.

Each day the stalemate drags on, it becomes more and more clear that the legislature needs to step in and examine every option that is at its disposal. I have spoken many times over the last several months about the importance of preserving access to stable, affordable health care. Both sides should be listening more closely to those who worry about losing their doctors.

As someone who represents many of those who are affected by the stalemate, I am committed to addressing these issues and using any viable option that leads to a positive outcome for those who lives are dependent on their health care remaining accessible to them.  All parties involved must continue to ask themselves what is best for the consumers of western PA. 

In the meantime, please feel free to communicate to me any additional concerns you might have about the dispute.