The answer to the question as to how Butler County residents will be affected by the expiration of a consent decree between UPMC and Highmark on June 30 remains unclear.

A judge ruled Friday that an agreement between the two health care conglomerates can't be extended through litigation past its expiration date later this month. As a result, the consent decree ending will lead to higher — and, in some cases, prohibitive — costs for Highmark customers seeking care in UPMC's network. The state's Supreme Court will likely have the final say.

UPMC has announced that Highmark customers could visit Pittsburgh's Hillman Cancer Center after the expiration date at in-network rates, and Highmark members in Butler can still receive care from UPMC providers here because of an agreement with the hospital.

The CEO for the Butler Health System told the Butler Eagle that the hospital signed long-term contracts with insurance providers to avoid any potential problems resulting from the expiration of the consent decree. He noted they've had more than five years to prepare for this.

But what happens when you step outside the footprint of the Butler Health System? If you get into a car crash or have a heart attack in Pittsburgh or need services or specialists not offered in Butler, then you could find yourself in a costly predicament.

Anyone who has ever sought treatment at a health care facility and dealt with insurance companies knows that the process can be a major hassle. But the latest in the UPMC-Highmark feud saga goes beyond annoyance or inconvenience. It will force people seeking care — perhaps, critical services — to jump through hoops for treatment. Many Highmark customers who have already started their care in the UPMC network will have to seek follow-up treatments elsewhere as of July.

In many cases, patients would be starting over with a new facility halfway through treatment for an ailment. And there are a number of problems — everything from lost records to appointment delays — that can arise when a patient is transferred from one provider to another.

Highmark and the state attorney general's office are in favor of extending the agreement between the health care entities, while UPMC is opposed to it. UPMC has been accused by some of employing hardball tactics to force Highmark members to switch their insurer and, therefore, rule the regional market. It's difficult to argue with this assessment.

UPMC and Highmark both have nonprofit statuses. There's an argument to be made that a nonprofit hospital should accept any insurance to keep that status.

We agree with Attorney General Josh Shapiro's assertion that the most important element to be considered in the matter is to “take steps to restore fairness to the health care system and give people access to the institutions their tax dollars built.”