Contentious contract talks between a major health care provider in Connecticut and a high-profile insurer remain unresolved weeks after the existing coverage agreement expired, leaving the future care of as many as 15,000 in limbo and patients caught in the middle of the dispute.
Experts say the tense tenor of the negotiations between Farmington-based UConn Health and health insurance giant Aetna, headquartered in Hartford, is not an isolated example. It is becoming increasingly common across the country in talks between health providers and insurers, often playing out publicly.
In Connecticut, the negotiations have been punctuated a highway billboard campaign by UConn Health.
“Both sides have reasons for drawing a line in the sand,” Angela S. Mattie, a professor of management and medical services at Quinnipiac University in Hamden, said, with rising health care costs at the core of the dispute. “This isn’t just Connecticut, its nationwide. Who loses here are the patients. So the patients are now stuck with the uncertainty of the market which, in itself, can cause a lot of angst and anxiety.”
Without a contract between provider and the health insurer, patients may find themselves suddenly “out-of-network” and facing significantly higher out-of-pocket costs to be treated by the same physician or other provider. The shift also can set off a scramble to find new doctors or specialists that accept the patient’s insurance.
Some relief for patients of UConn Health — an arm of the University of Connecticut — with Aetna coverage may soon be on the way. The existing contract expired Nov. 30.
In a statement to The Courant late last week with a tone that turned down the volume, Aetna said: “We’re continuing to have collaborative conversations with UConn and expect to have more to share next week.”
UConn Health’s chief executive Andy Agwunobi issued this statement to The Courant on the issue: “UConn Health continues to work closely with Aetna in ongoing discussions aimed at reaching an agreement that ensures patients’ access to our high-quality care. We are optimistic that we will soon reach a resolution. Throughout this process, our priority remains centered on patient access and long-term sustainability.”
State Comptroller Sean Scanlon said late last week that the negotiations between UConn Health and Aetna — owned by Woonsocket, RI-based CVS Health Corp. — now appear to be on the “one-yard line.”
As comptroller, Scanlon runs the state’s largest employer-sponsored health plan, covering state and municipal employees and retirees, as well as their dependents. Scanlon said he doesn’t take sides in talks such as Aetna-UConn Health, but he said he works behind-the-scenes, encouraging both parties to reach a resolution.
“Unfortunately, these disputes are becoming both more common, and the period of dispute is becoming longer, Scanlon said.
In December, four members of Connecticut’s Congressional delegation — U.S. Sens. Richard Blumenthal and Christopher S. Murphy, and U.S. Reps. John B. Larson and Rosa L. DeLauro — wrote to the top executives of Aetna and UConn Health urging a quick resolution to the dispute.
The Dec. 8 letter said the delegation had heard from worried constituents, prompting concern among the delegation about possible financial hardship “or worse — require them to forgo medically necessary services because they cannot afford such services.”
‘Shouldn’t have to fight’
Stephanie Nicholson knows that worry well.
The Waterford resident makes the hour-plus ride to UConn Health to see specialists that monitor her multiple sclerosis — diagnosed when she was 21 — and the after effects of surgery to remove a brain tumor in 2022. She’s seen many of the same doctors for years, following some of them to UConn Health.
Nicholson, 56, is covered by Aetna through her husband’s employer, an aerospace and defense company. If she sought care as an out-of-network patient, Nicholson said she and would face thousands of dollars of additional, out-of-pocket costs annually. The only other choice of health insurance from her husband’s employer also is out-of-network for UConn Health.
Nicholson, a former restaurant owner who now is on disability, said she worries about finding another primary-care doctor that can refer her to new specialists. Those include a neuro-ophthalmologist who monitors Nicholson’s two-thirds vision loss resulting from the brain surgery.
“First, you have to find a primary care doctor that’s actually taking new patients, and then as a new patient, your wait for your first visit is anywhere from six to eight months, if not a year,” Nicholson said. “They’re just so overloaded.”
“So, in the meantime, then I go without the annual scans, the annual testings — whether it’s my eyes — I see my doctor every three to four months — blood work, things like that. They do different neurological tests when I go up there. They’re all timed.”
Nicholson said her frustration only has grown since the UConn Health’s contract with Aetna, owned by CVS Health Corp., expired on Nov. 30. Some of those covered did not lose their “in-network” status until Feb. 1. Nicholson said she successfully lobbied for an extension that ends March 1.
“I shouldn’t have to fight to be covered just because you guys can’t agree,” Nicholson said.
Gaining negotiating clout
At issue in the contract negotiations are the reimbursement rates for services that Aetna pays to UConn Health — the parent of John Dempsey Hospital, a network of clinics and more than 700 providers.
Early on in the contract talks, both Aetna and UConn Health lobbed public accusations that each other was not presenting reasonable proposals. UConn Health said its reimbursement rate was among the lowest for hospitals in Connecticut.
Quinnipiac’s Mattie said health systems like UConn Health do face sharply rising costs for labor — especially with the shortage of trained nurses — pharmaceutical and supplies. On top of that, UConn is a teaching hospital and higher costs associated with training physicians.
“So the bottom line is that you have hospitals that have increasing costs and their outcome is to get, from the insurer, more money to cover their costs,” Mattie said.
UConn Health’s John Dempsey Hospital in Farmington. (File photo)
A 2025 report by the American Hospital Association found that hospital expenses increased 5.1% in 2024, faster than the 2.9% inflation costs. Labor costs were the biggest component, the study found, with advertised nursing salaries rising 26.6% faster than inflation, between 2020 and 2024.
Health care systems — and hospitals, in particular — are gaining more clout in negotiations amid rapid consolidation.
According to KFF, a nonprofit organization that provides information, analysis, and research on health care issues, there have been 2,000 hospital mergers nationally since 1998, including 428 hospital and health system mergers announced from 2018 to 2023.
UConn Health also is expanding in a $13 million deal to purchase the ailing Waterbury Hospital. The acquisition was recently approved by the state Office of Health Strategy.
“The share of community hospitals that are part of a larger health system also increased from 53% in 2005 to 68% in 2022,” according to KFF, the former Kaiser Family Foundation. “Relatedly, the share of physicians working for a hospital or in a practice owned at least partially by a hospital or health system increased from 29% in 2012 to 41% in 2022.
Health insurance squeeze
On the other side of the negotiations are the health insurers “who are saying, ‘Wait a minute, I have employers that are telling me to keep costs down,’ ” Mattie said. “So my outcome is to negotiate the best possible rate.”
An annual study of large and small businesses last fall by KFF found that family premiums for employer-sponsored health insurance reached an average of $26,993 in 2025, with workers contributing $6,850 to the total.
Family premiums rose by 6%, or $1,408, in 2025 compared with the previous year, similar to the 7% in each of the previous two years. The increase in 2025 compares with general inflation of 2.7% and wage growth of 4% in the same period, according to the KFF study.
In addition, health insurers have to assess the consequences for their own profitability, Mattie said.
Once, the negotiations between health insurers and providers were, for the most part, behind closed doors but not anymore, Mattie said.
UConn Health took out billboards on major highways in Connecticut, part of a strategy to pressure Aetna in the negotiations.
The health system used a similar strategy in early 2025 when it was negotiating with Farmington-based ConnectiCare, a unit of California-based Molina Healthcare.
“Both sides are now using the media to get to patients, to get to the press, to get to the public, to sway,” Mattie said. “So, they’ve become more sophisticated in making it making it a pr. dance than before. And then, deadlines essentially becomes suggested closing times, not necessarily a deadline. It’s not just UConn-Aetna. These things are happening nationwide.”
Kenneth R. Gosselin can be reached at [email protected].