SAN DIEGO (FOX 5/KUSI) -- Anthem Blue Cross and Scripps Health have less than two weeks to come to an agreement. In the meantime, about 125,000 patients in San Diego are in limbo.
Scripps and Anthem's contract expires on December 31, 2024, and the two companies are pointing the blame at each other, while Anthem Blue Cross policyholder and Scripps Health patient Lisa Schmidt feels caught in the middle of a corporate contract.
"I have a condition called Ehlers-Danlos syndrome," Schmidt said. She also battles a myriad of health issues including POTS, asthma and others, most of which were brought on after COVID-19.
"All I do is go to doctors," Schmidt said. "I feel like I'm always at someone, I saw the pain doctor this morning."
In a matter of days, she could lose her care, or have to pay out of pocket for her doctors and specialists through Scripps Health because of the ongoing contract negotiations.
"I don't know what I'm going to do," Schmidt said. "This is my life and then I'm going to be abandoned by the medical that I've been receiving."
If they can't come to an agreement, she's worried she will need to find new doctors and specialists, potentially travel to another county, or pay out-of-pocket to get the same care she's been receiving. She said it's not easy finding new healthcare providers with a chronic illness.
"It would mean replacing a ton of specialists, I mean it's scary and it's overwhelming for somebody who does not feel well to even think about that," Schmidt said.
Schmidt, seemingly caught in the middle, as Scripps and Anthem Blue Cross are pointing the blame at each other.
"It's devastating living like this, never mind being told by corporate CEO's that you cant have care, healthcare is broken in this country and it needs to change," Schmidt added.
Both Anthem and Scripps said they are negotiating in good faith.
Scripps Health released the following statement on the negotiations:
"Scripps Health is dedicated to making a positive difference in the health of the communities we serve, which is why we continue to negotiate, in good faith, to try to reach agreement with Anthem Blue Cross. We understand that contract negotiations between health care providers and health plans can create uncertainty for patients who may be impacted. It is important to know that Scripps is negotiating with Anthem as an advocate for the best interests of our patients. As a health care provider, we exist to take care of people, but we can only do so if Anthem amends their current policies that cause unnecessary burdens and barriers to care. We hope that Anthem shares our sense of urgency. Patients are encouraged to reach out to their human resource or benefits departments, or directly to Anthem, to understand how a change to their health care network might impact their access to care, to learn how it could impact their out-of-pocket costs, and to share their concerns about keeping access to Scripps Health's high-quality care."
Anthem Blue Cross released the following statement on the negotiations:
"Anthem and Scripps' contract agreements are set to expire and we are working to extend our members' access to affordable care at Scripps Health beyond December 31, 2024. We recognize that having in-network access to their facilities is important to our members and their employers in San Diego County. However, we are concerned that Scripps wants to drastically increase its prices for patients covered by Anthem. These increases will lead to higher out of pocket costs for our members and would hit area employers particularly hard. More than 80% of Anthem Blue Cross members are insured by employers that pay their employees' healthcare costs directly. We will continue to work in good faith with Scripps to reach a new agreement. In the event an agreement can't be reached, we are taking steps to ensure our members currently in treatment at Scripps Health may continue care with their current care provider after January 1. In addition, our network in San Diego County includes several other high-quality health systems including UC San Diego Health, Sharp HealthCare, Rady Children's Hospital, Palomar Medical Center and others. Members may call their member service center at the number on the back of their ID card for assistance. They may also visit anthem.com/ca/scrippshealth for the latest information."
Scripps Health released another update on Tuesday you can view online at scripps.org/anthem.