Northern Light Health and Anthem Insurance are at an impasse over a new contract, potentially impacting 30,000 Mainers\u2019 network status by October 1.<\/p>\n
MAINE, USA \u2014 Northern Light Health and Anthem Insurance are still far from reaching a consensus on a new contract. If no deal is reached, in little more than a month, 30,000 Mainers will find their primary care provider out of network.<\/p>\n
Earlier this month<\/a>, Northern Light called off negotiations with Anthem Insurance. According to the system\u2019s website, \u201c[Anthem\u2019s] apparent unwillingness to come to the table and work toward a mutually agreeable contract\u201d led Northern Light to pull out of talks.<\/p>\n More than a week later, a Northern Light spokesperson said there is \u201cno update\u201d on the contract.<\/p>\n The stalemate between the two health companies is not the first in recent years. In 2022, Maine Health and Anthem were at odds over their own negotiations.<\/p>\n \u201cIt feels like an exact replay to be quite frank,\u201d said Dr. Julie Pease, chair of Maine AllCare<\/a>, a group advocating for a single provider healthcare system.<\/p>\n If no agreement is reached by October 1, Northern Light physicians and specialists will be out of network for Anthem customers. \u00a0<\/p>\n Policy director at Consumers for Affordable Health Care,<\/a> Kate Ende, emphasizes that emergency care will remain in network.<\/p>\n \u201cSo somebody has an accident and needs to go to the emergency room. They don’t need to worry about whether or not that’s an in-network facility,\u201d Ende explained.<\/p>\n She also says that under Maine Law<\/a>, insurance companies are required to make sure customers have adequate access to care providers in a region.<\/p>\n \u201cI would assume it would be really hard to meet that obligation,\u201d Ende said. Meaning, given Maine\u2019s rural nature, Ende said Northern Light may end up in the network anyway for some patients.<\/p>\n Ende and others are watching the contract negotiations, but patients do not seem to be overly concerned. Instead, she says the larger concern is the proposed increases to insurance premiums.<\/p>\n \u201cDouble digits, you know, 20-25% sometimes more, depending on what plan you’re in,\u201d Ende said. The rate increases are fueled partially by pharmaceutical costs and wage increases, but also by the insurance rate discussions.<\/p>\n According to Pease, the rising cost of healthcare is becoming unaffordable. Pease said that the negotiation stalemate shows why Maine needs a tax-based care system.<\/p>\n \u201cIt’s really becoming a disaster situation,\u201d Pease said.<\/p>\n Shopping around among different insurance companies is one way consumers can save some money. One of the many firms in contract with Northern Light is Community Health Options<\/a>, a Maine-based provider.<\/p>\n The insurance company and Northern Light recently announced<\/a> a new payment agreement to alleviate administrative costs as well as two new coverage plans for Mainers in Penobscot, Piscataquis, Somerset, Hancock, Aroostook, and Washington counties.<\/p>\n Joanne Lauterbach, chief financial officer at Community Health Options, says the billing agreement is already in place, and the new coverage plans begin January 1, 2026.<\/p>\n Lauterbach says the collaboration between the two companies is part of a shared vision.<\/p>\n \u201cTo ensure that they have the care that they need,\u201d said Lauterbach. \u201cWe want to make sure that we have a healthy state, healthy members, and make sure that they have access to ensure that they remain healthy.\u201d<\/p>\n However, shopping around is not going to be perfect. Ende says some plans and providers are not going to meet all needs, even going as far as to say, \u201cthe vast majority of services are not shoppable.\u201d<\/p>\n NEWS CENTER Maine contacted Northern Light Health and Anthem Insurance; however, representatives for both companies said an interview was not possible.<\/p>\n