The end of the health insurance coverage contract between Anthem Blue Cross and Scripps Health has left thousands of San Diegans facing a healthcare crisis. Patients relying on Scripps providers for their care must now seek alternatives or navigate complex options for continuity of care, a fallout from months of failed negotiations between the two organizations.
A Stalemate Over Costs
Effective January 1, Scripps Health providers are now considered out-of-network for patients covered by Anthem Blue Cross and Covered California. Both sides blame each other for the impasse, citing rising costs and bureaucratic barriers as sticking points. Anthem claims Scripps demanded “drastically increased prices,” which would result in higher out-of-pocket costs for patients, while Scripps contends that Anthem’s policies create unnecessary delays and fail to meet inflationary healthcare costs.
“Both of these are billion-dollar organizations, and in the middle of this are people in the community trying to get their healthcare done and trying to do it economically,” said Todd Walters, president of the local 135 United Food and Commercial Workers Union.
The Impact on Patient
The fallout affects a significant portion of San Diego residents. Walters estimates that up to 10,000 union members alone are impacted, while Anthem members across the county must now switch to alternative providers like UC San Diego Health, Sharp HealthCare, and Palomar Medical Center to maintain in-network coverage. Patients with ongoing complex medical needs may apply for Continuity of Care accommodations, but such arrangements are limited and case-dependent.
Scripps Health has assured patients that emergency care will remain covered under all circumstances. However, those seeking non-emergency care at Scripps facilities are encouraged to contact Anthem to understand changes to their coverage and potential out-of-pocket costs.
Navigating the Fallout
Both Anthem and Scripps have issued public statements expressing their willingness to continue negotiations, but the termination leaves patients and employers in a difficult position. Walters noted that his office has been flooded with calls from concerned union members. “Our office has been getting calls for over a month now dealing with, ‘What am I supposed to do? Where do I go?’” he said.
For now, affected patients are encouraged to explore alternative in-network providers or discuss healthcare options with their employers. Employers offering Anthem plans are also being notified of the contract termination and may consider adding additional insurance options to accommodate employee needs.
While negotiations remain ongoing, the immediate priority for many San Diegans is finding a path to affordable, reliable healthcare amid the disruption.
