Patients could lose in-network care if Ascension and Blue Cross don’t reach a deal by Jan. 1

People with Blue Cross and Blue Shield insurance may lose access to in-network care at Ascension Seton facilities in the Austin area on Jan. 1 if the two entities do not agree on a new contract before that time. The negotiations also apply to Ascension Providence facilities in Waco.

Some insurance holders in the Austin area received a postcard from Blue Cross Blue Shield of Texas alerting them to the upcoming deadline.

“We’re working hard to reach an agreement, but if we don’t, Ascension hospitals will no longer be in your network as of Jan. 1, 2026,” read the notice, dated. Dec. 1.

The contract negotiations center on the insurer’s hospital and facility agreements with Ascension. If a deal is not struck, patients with coverage through commercial BCBSTX policies would be affected, as would those enrolled in BCBSTX Medicare Advantage plans or Affordable Care Act exchange plans.

According to BCBSTX, policyholders who are pregnant, disabled or being treated for an acute condition or life-threatening illness may still be able to qualify for “continuity of care,” meaning they would still be able to receive in-network rates. In the notice sent to policyholders, BCBSTX said members should call the number on their member ID card for more information if they believe these circumstances apply to them.

BCBSTX has struck a number of eleventh-hour contract deals with Texas hospitals and health care providers after contentious negotiations. In 2023, the insurer and Ascension arrived at a deal ahead of a similar deadline. Last year, BCBSTX and Baylor Scott & White Health also resolved extended negotiations.

“Our goal is to protect our members’ and customers’ access to quality care at cost-effective rates,” a BCBSTX representative said in a statement.

Ascension posted a page on its website with details about the ongoing contract negotiations.

“We regularly negotiate with insurance companies to ensure fair contracts that support the sustainability of our care and our people,” a statement on the webpage said. “We are currently in discussions with Blue Cross Blue Shield of Texas to reach a new fair and sustainable agreement that reflects today’s healthcare realities — including historic inflation, rising medication prices and increased costs for life-saving equipment and supplies.”

BCBSTX is the largest health insurer in Texas, holding about 25% of the market share, per the Texas Department of Insurance. Ascension Seton operates 12 hospitals in Central Texas, including Ascension Seton Medical Center in Central Austin, Dell Seton Medical Center at The University of Texas and Dell Children’s Medical Center, as well as dozens of primary and specialty care clinics.