As the first quarter of 2021 comes to a conclusion, there is still apparently no agreement to restore the network relationship between United Healthcare (UHC) and Montefiore Health System. There is no indication that negotiations are occurring at this point. Someone has suggested that the organizations will be reviewing the financial impact this split has had in the first quarter and that may determine the urgency with which negotiations are pursued.
Those who have coverage with UHC and medical care with Montefiore doctors, specialists or facilities don’t need to wait for a report to describe the financial and health impacts that this split has caused. The press reports that the number of people affected is approximately 60,000, many in the Bronx and Westchester. Without doing much to raise awareness of this problem, we have heard from a lot of people who have been affected. Finding new doctors, renewing prescriptions, making arrangements for new surgical needs are all stories we have heard from people with whom we work and people that we know in the Bronx and Westchester. Some people continue to be surprised to find out that their doctor is no longer in network.
Several Bronx groups, including University Neighborhood Housing Program, have repeatedly contacted both UHC and Montefiore directly to urge them to work out their differences. We have heard from representatives from both expressing their sympathy and explaining that they have not been able to reach an agreement because the other side is unreasonable. We’ve explained that sympathy doesn’t make our health issues go away. While the conversations have been courteous, they have not brought results.
We are aware that a number of our elected officials have spoken out and/or have written letters to UHC and Montefiore. Representatives Bowman, Espaillat, Jones, Ocasio-Cortez and Torres co-signed a letter to both back in January; Assemblyman Dinowitz wrote a letter to both; Congressman Torres and Bronx Borough President Diaz had separate press conferences; Senator Biaggi asked the NYS Superintendent of the Department of Financial Services Linda Lacewell about it; the Superintendent said she had reached out to both CEO’s to urge them to work it out. There has been little media coverage by CBS, NY1, and the Daily News.
Still, nothing has worked thus far. The effort will continue, but the fact that there has been so little progress is troubling for a few reasons in addition to the obvious health implications for the individuals caught in the middle.
First, the assumption that having health insurance through your employer allowed you to feel comfortable with affordable and reliable health coverage has been undercut. The fact that this has happened now with a major insurer and a major hospital system makes one wonder whether any coverage is in fact reliable and any relationship with a doctor will last. It has led to spending time learning more about the proposed NY State Health Act and federal proposals for Medicare for All.
Second, the fact that the intervention of elected officials at the state and federal level has not had an impact suggests a lack of accountability in the country’s health and insurance industry.
Finally, the lack of media coverage about this battle is puzzling. 60,000 people in New York City and Westchester left in uncertainty about their health insurance and their doctors in the middle of a pandemic seems like it would merit some attention. Is the issue really too complicated for the press?
We don’t give up easily in the Bronx. We’re going to keep battling until we get a resolution that works. Stay tuned as we increase our efforts in the coming days and weeks.