On June 1, Aetna and UW Medication didn’t agree on a brand new insurance coverage contract. Greater than 50,000 Aetna members discovered that each UW hospital, clinic and physician was now out-of-network, forcing them to decide on between paying sky-high payments or abandoning physicians they’ve trusted for years.
Who’s at fault? Both sides blames the opposite, and the talks are closed to public view. The one certainty is the loser: sufferers. I do know this firsthand. I educated at UW in inner drugs, nonetheless ship my sickest hospital sufferers there for transplants and superior most cancers care, and carry Aetna insurance coverage by means of my employer. When the deal collapsed, sufferers suffered, and clinicians scrambled. If this sounds unhealthy, think about the way it feels for my affected person who is barely midway by means of a chemotherapy routine at UW.
Aetna, a part of CVS Well being, shoulders many of the blame. CVS cleared $4.6 billion in revenue final yr, and its inventory is up more than 50% in 2025. CEO David Joyner made over $17 million in 2024. Incoming Aetna CEO Steve Nelson stated the quiet half out loud at a 2019 UnitedHealth city corridor: Insurers lobby “much more than you’d assume” in opposition to reforms like Medicare for All — however strive not to attract consideration, as a result of “the very last thing you wish to do is grow to be the poster youngster.”
Aetna has used this playbook earlier than, letting contracts lapse with Windfall in Oregon and clashing with California’s Sutter Well being. An organization that rewards its leaders and shareholders so richly can afford to maintain UW Medication in-network.
UW Medication, a public nonprofit, faces actual headwinds: looming Medicaid cuts and unsure federal analysis funding. However UW has obligations, too. Federal guidelines require hospitals to publish detailed tariffs so the general public can see what every insurer pays. UW’s data nonetheless lacks the specificity wanted to confirm its claims about Aetna’s charges.
UW’s previous strategy to negotiations with its personal resident doctor union additionally raises issues about how persistently it bargains in good religion. If UW needs public belief, it ought to publish clear, detailed monetary reviews so sufferers, voters, and lawmakers can decide how effectively public {dollars} are being spent.
What can we do now? In case your employer affords Aetna, converse up. Inform HR and firm leaders you count on a plan that retains UW in-network, or that you really want a special service if no deal is reached. If you happen to purchase your individual coverage, or have an Aetna Medicare Benefit plan, put together to modify throughout open enrollment on Oct. 15, and let Aetna know why you switched.
Second, contact your lawmakers. Assist Washington House Bill 1589, which requires insurers to cut price in good religion and expands state oversight. However urge lawmakers to strengthen it by changing its $5,000 advantageous with a penalty sufficiently big to matter.
Lastly, demand transparency. Ask Aetna and UW for normal public updates — not simply finger-pointing, however actual details about what’s holding up the deal.
Extra broadly, we should repair the system that allows this. Employer-sponsored insurance coverage, which is how half of Individuals nonetheless get protection, ties well being safety to employment. Lose your job and also you lose care. Keep in a job you’ve outgrown, and also you’re captive to no matter community your organization chooses. Many individuals stay in jobs they’d in any other case go away simply to maintain seeing their docs, distorting the labor market and suppressing wages.
The U.S. is almost alone amongst rich nations in clinging to this mannequin. A single-payer system would observe us from job to job, lower administrative waste and direct {dollars} to care relatively than shareholder dividends. Insurance coverage firms worry that future. Sufferers shouldn’t.
Till we construct one thing higher, contract breakdowns like this can maintain deciding who will get handled — and who will get shut out.
