KANSAS CITY, Mo. — Soon, an unknown number of children will lose access to care through their health insurance at a children’s hospital in Missouri, a number that could climb into the tens of thousands.
The potential disruption comes as Children’s Mercy and Blue Cross Blue Shield of Kansas City remain at odds, failing to reach a compromise over coverage for families who rely on plans purchased through the ACA health insurance marketplace.
Renzo Luzzatti, an expert in the health care industry, warns that the dispute highlights a deeper problem in the system, asking when we draw the line.
Luzzatti, President and CEO of US-Rx Care, says the situation reflects a troubling reality for families who depend on marketplace insurance.
“It’s really sad. This is a testament to where we are in the healthcare industry,” he said.
Now, families across the metro are left trying to figure out what they will do if their children need hospital care.
The concern intensified after Blue Cross and Blue Shield of Kansas City, also known as Blue KC, made the decision to cut its ACA marketplace offerings in the Kansas City Metro area. They will no longer consider Children’s Mercy or any of its pediatric clinicians as in-network providers.
Luzzatti says the issue extends beyond this single contract dispute.
“This insurance model, this insurance platform is underfunded – funding that was supposed to come from the federal government to offset the level of risk that these plans,” he said.
The same health care exchange is currently at the center of a battle in Congress, with subsidies set to expire January 1, a move experts say could send premiums skyrocketing.
For families with Blue KC plans purchased on the health exchange, the stakes are especially high.
The next closest children’s hospital comparable to Children’s Mercy is more than four hours away, in St. Louis.
NewsNation affiliate WDAF reached out to Blue KC for comment and is waiting for a response.
Luzzatti says while both parties share responsibility, there are no winners in this standoff, especially the children caught in the middle.
“They got to come to a compromise – this doesn’t serve anybody – because again we’re talking about people who have no other option for health insurance, that’s why they’re on the exchange,” he said.