Health insurance quagmire: Clark County residents face difficult choices after Regence splits with Legacy Health

May 2—Julia Paddison's 6-year old daughter, Charlotte, has struggled since she was diagnosed with Char syndrome, an extremely rare genetic condition that affects the development of the face, heart and limbs.

Since she was 2 years old, Charlotte's family has spent an unimaginable amount of time, money and energy into finding a team of medical professionals that could best support her daughter.

They ultimately found it at Legacy Health. Now the Lake Shore family has no choice but to start looking for other options. Regence health insurance cut Legacy Health providers from its network after the two organizations failed to reach an agreement on a new contract on April 1.

Paddison's daughter is one of roughly 9,300 Clark County residents with Regence insurance affected by the change.

Regence and Legacy have since returned to the table to negotiate a new contract, according to Merrin Permut, vice president and chief population health officer for Legacy Health. But it's unclear when — or if — the two organizations will reach an agreement.

"There were some conversations really focused on the patient impact and encouraging Regence to continue dialogue," Permut said. "That has kicked off conversations and a new round of negotiation occurring. We're encouraged by that and hoping we can make progress and hopefully reach an agreement soon."

A spokesperson for Regence confirmed the health insurance company is in negotiations with Legacy Health's team with the goal of reaching an agreement on healthcare prices that are fair and sustainable.

While Paddison said she hopes Regence and Legacy can reach an agreement to keep her daughter's current providers, she's left feeling frustrated being caught in the middle of their disagreement.

For medically vulnerable patients who depend on consistent care, having a group of medical professionals who understand a patient's medical history can make a world's difference.

Paddison said the detailed notes and devoted care from Charlotte's Legacy endocrinologist help her get the growth hormones she needs to stay healthy, a treatment often denied by Regence, requiring a lengthy appeals process to get coverage approved. Even then, it comes at a monthly cost of $1,000.

"This is my daughter's future," Paddison said. "It feels like they're playing with the safety of my daughter. I want them very much to know that there's nothing more sacred than the lives of the people that they are negotiating with. I feel like that's become the norm in this country where the needs of patients are overlooked for profit."

Legacy Health and Regence negotiations began months ago, with Legacy asking for higher reimbursement rates due to higher operating expenses. From 2021 to 2025, Legacy's operating expenses — such as labor, supplies and regulatory costs — have risen 47 percent, according to an open letter from Permut in April.

Despite operational improvements and efficiencies, like closing all Washington Legacy-GoHealth Urgent Care clinics due to financial challenges, these measures haven't kept pace with rising expenses, Permut said.

Pain clinic closure

Fleur Evers, 52, of Felida, said she was one of the patients affected by the closure of the Legacy Salmon Creek Pain Clinic at 2101 N.E. 139th St., which ended operations in March.

Evers, insured by Regence through her Medicare Advantage Plan, had been receiving treatment for chronic pain related to a spinal injury at Legacy Salmon Creek since 2018. When the pain clinic shuttered, she thought her care would be transferred to Legacy Good Samaritan in Portland.

With Legacy being out of network for her insurance plan, she's considering changing her health plan during open enrollment in October. However, a dwindling number of insurers in Clark County for Medicare Advantage plans has left her with little options that fit her needs.

"It's always upsetting when you have a choice that's taken away," Evers said. "There's no instant fix, but I feel like patients are the pawns."

Healthcare costs continue rising

Nathalie Johnson, medical director of Legacy's cancer institute, said healthcare costs accelerated significantly after the COVID-19 pandemic. Since then, the cost of labor has increased and staffing has reached critical levels, leading to worker shortages in specialty care services.

Over the past several decades, health spending in the United States has risen considerably, often outpacing inflation, according to KFF, an independent public health nonprofit. In 2024, the amount spent on healthcare and other expenditures — such as the administration of insurance, health research and public health — reached $5.3 trillion.

Federal and state pressures, such as cuts to Medicaid and Medicare reimbursement rates, also have made it difficult for hospitals to cover the cost of care.

"It's really hard to see people not having access to care," Johnson said. "I think that's really why both parties are back at the table, because there are not enough (healthcare workers) to absorb all these patients."

Wait and see

Dave Ernst, 77, who was referred by a Legacy oncologist to receive cancer treatment at Oregon Health & Science University, said he's looking at the disagreement with Legacy and Regence with watchful eyes.

Regence might end its in-network relationship with OHSU by the end of this year if the two organizations cannot reach an agreement on a new contract, which expired Dec. 31.

"It makes you concerned," Ernst said. "I just try not to look too far ahead."

This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj.

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