In my role as a State Senator, I have received many calls from patients and their families expressing concerns that are all too common today: They are anxious, confused and frustrated because they find they can no longer see their trusted health care provider.
These sudden changes will cause sleepless nights and huge stress for hundreds of people in our region and could have devastating effects on public health.
Senator Saud Anwar (D-South Windsor, Maryland)
I recently had a lengthy discussion with one of my constituents, who requested anonymity so I will call her Diana. She is a retiree in her early 70s who suffers from a debilitating and potentially life-threatening autoimmune disease. She has been under the close care of doctors at Trinity Health for over a decade. The complexity of her condition and her sensitivities to various medications have made it difficult for her to maintain control, spending countless hours on tests, treatments and approvals.
Diana's health has finally improved thanks to a specific medication. Without the tireless efforts of her medical team, it would never have been possible to find an effective medication for her treatment. But shortly after this breakthrough, she recently received a letter informing her that she could no longer see those responsible. Her UnitedHealthcare insurance no longer covers Trinity Health's medical providers. Since I began writing this commentary, the parties have reached a settlement, but for Diana, it is too little, too late. The cumbersome process of getting approval for treatment has transformed her fragile health.
Trying to navigate this change, Diana called UnitedHealthcare's helpline but was met with an inefficient automated system and hours of frustrating conversations. Despite persistent negotiations, she was ultimately told it was her responsibility to find a new doctor and transfer her medical records. The experience left Diana feeling abandoned and overwhelmed, especially since not finding the right care and insurance could mean her life-saving medications won't be covered.
Diana found a new specialist, but found herself unable to see him for several months due to backlogs. Meanwhile, she struggled to manage her complex health condition. Diana was also unsure whether her new team could meet the demands of her condition, given her 10-year history of multifaceted care. She had built a trusting relationship with her doctor, but that relationship was no longer there for reasons that were not her fault.
Diana's plight is not uncommon. Many patients like her are caught in the middle of contract disputes between healthcare providers and insurance companies. A 2023 survey found that more than half of patients have experienced delays in care caused by their insurance company, negatively impacting their health. Insurance company negotiations often ignore the human lives affected by the outcomes, and patients who rely on consistent, familiar care bear the brunt of these disruptions.
There is an urgent need to enact legislation that protects patients during insurance transitions. When an insurance company’s contract with a healthcare provider is terminated, patients should have the right to switch to another insurance plan while continuing their current treatment without incurring additional costs. Otherwise, patients will suffer because of decisions that are completely out of their control. Patients’ medications and treatments should not be interrupted, and out-of-network doctors should receive fair compensation for continuing treatment.
Known for its profitability and generous executive compensation, UnitedHealthcare must remember that its first obligation is to the health and well-being of its policyholders, above that of its shareholders and directors. Financial performance is important, but it should not come at the expense of patient care. The health of our communities must be the number one priority guiding our decisions and actions.
In these challenging times, we must make quality and access to health care our top priority. We cannot allow the relentless pursuit of profit to undermine the survival and well-being of our people. As we move forward, let us strive to ensure that our health care system is patient-centered, compassionate and fair. Only then can we say we are truly serving the best interests of our communities.
