Dispute Leaves 12000 in Fresno Without In-Network Coverage

In Fresno, California, a contractual dispute between Blue Shield and Community Health System has left 12,000 members without in-network insurance coverage for nearly three weeks, critically impacting 5,000 municipal employees. Highlighting this issue is Fresno City Council President Mike Karbassi, noting that the area's only Level One trauma center is affected due to its lack of in-network status. This situation has sparked concern among city authorities who are considering bypassing the insurer to negotiate directly with Community Health System, aiming for a swift resolution through the Health and Welfare Trust.

While Blue Shield claims Community Health System terminated their contract, Community contends the insurer failed to offer a contract extension. Meanwhile, just recently, Community restored coverage for 6,000 Fresno Unified retirees on Aetna’s insurance plan. This follows incidents like that of former teacher Emily Brandt, who, facing a rare cancer diagnosis, was forced to look outside the region for care after her access to in-network treatment at Community was lost under Aetna’s plan. Her experience emphasizes ongoing questions about Community’s negotiating practices, which city leaders are scrutinizing.

Karbassi has pointed out Community Health System’s openness and readiness to negotiate, emphasizing their cooperative stance compared to Blue Shield. He remarked, “They’re on notice as much as Blue Shield, but they’re the ones willing to negotiate directly with our trust.” Stay informed on this evolving situation by following updates from Gabe Ferris’s social media channels for the latest developments.