The Middletown Press (Middletown, CT)
Prodded, insurers move toward providing free tests
WASHINGTON — It’s clear health insurance will cover a coronavirus test for most Americans who need one. But how much will insured people have to pay for it?
The answer could dramatic effects on how many people are tested, which could influence the spread of the disease and how it is treated around the country.
As events unfold quickly, federal and state officials are wrestling with the insurance question — whether covered people should have any co-payments and whether the tests should be subject to deductibles, for example.
They’re also sorting out insurance coverage of Covid-19 treatments and the eventual vaccine, which won’t be ready until well into 2021 at the soonest, experts say. And Congress debating how to make corona virus related healthcare affordable for millions of Americans who lack insurance.
On Tuesday, President Donald Trump and Vice President Mike Pence met with nine health insurance executives at the White House — some from Connecticut — to discuss how private insurers are responding to the outbreak.
The Trump administration has already directed Medicare and Medicaid to cover the costs of coronavirus tests. But details on how much insured Americans will pay out-of-pocket for the covered test are still emerging, as is coverage information for therapeutics and vaccines. It’s a key issue insurers, some of whom are major employers in Connecticut, are confronting now.
The White House meeting Tuesday included leaders from Anthem, which operates the Blue Cross and Blue Shield brand in several states; UnitedHealth Group; Aetna/CVS Health; and Bloomfield-based Cigna — all with large operations and sales in Connecticut — as well as the heads of Humana, Centene Corp. and Kaiser Health Plan Inc.
These companies agreed to “waive all co-pays” for coronavirus testing and “extend coverage for coronavirus treatment in all their benefit plans,” Pence announced Tuesday. They also agreed to “no surprise billing” for medical services, Pence said, referring to hefty bills for out-of network services that a customer can’t control, such as in emergency rooms.
Some of these companies have gone a step further, promising coronavirus tests will come with “no out-ofpocket costs” — meaning no co-pays, coinsurance or deductibles. Aetna/CVS Health, United Health Group and Anthem Blue Cross Blue Shield in Connecticut have made such promises in statements to the press.
Wendy Sherry, president of Cigna’s Connecticut market said Tuesday, “Cigna will cover the full cost of COVID-19 testing for our customers when it’s prescribed by a health practitioner.”
Humana will also waive “out-of-pocket” costs associated with COVID-19 testing, according to the trade association America’s Health Insurance Plans, which also attended the Tuesday White House meeting.
The private insurers who attended the White House meeting will also cover telemedicine services, Pence said. A coronavirus bill signed by Trump Friday will also allow seniors using Medicare to access telemedicine services for coronavirus treatment in their homes.
“I think that tremendous progress is being made,” Trump said Tuesday.
Connecticut Gov. Ned Lamont and Insurance Commissioner Andrew N. Mais have “encouraged” all Connecticut health insurers regulated by the Connecticut Insurance Department to promise no out-of-pocket costs for a provider visit and testing or telehealth treatment for COVID-19.
“I’m encouraging all employers to follow the lead of the health insurance industry in affirming that their plans will be covering coronavirus testing with no outof-pocket costs,” Connecticut’s healthcare advocate, Ted Doolittle, said.
State Senate Democrats in Connecticut sent a letter to Lamont Friday, asking that he require all insurers to provide the testing with no cost to consumers. It’s unclear whether Lamont could order that, but on Tuesday, Sen. Matt Lesser, D-Middletown, co-chairman of the legislature’s insurance committee, issued a statement praising the actions by the governor and insurance department.
New York went further, requiring all health insurers in the state to waive all costsharing associated with coronavirus testing, including emergency room, urgent care and office visits. Washington state also issued an emergency order requiring insurers to waive co-pays and deductibles for any person needing a COVID-19 test.
Both New York and Washington have over 100 confirmed cases of coronavirus. Connecticut had two confirmed cases, as of late Tuesday, at least one of which was contracted on a visit to California, health officials said.
Left unsaid in the push for free coverage of coronavirus testing and treatment is how the costs will be covered in the long run. At the state level, where insurers and regulators haggle every year over allowable rates, coronavirus coverage is likely to become part of the mix of costs — which could raise rates on all plans.
Ensuring coronavirus health care is affordable is fore of mind for Democrats in Congress, who are pressing for additional measures in possible new legislation to address the outbreak.
“When there’s insurance coverage available, that’s probably the best way to pay for it,” Sen. Chris Murphy, D-Conn, said about coronavirus health care. “That’s why we have insurance. But for those who don’t have an insurance to cover it, then as a public health matter we should ensure that cost isn’t a barrier to getting tested and getting treated.”
House Speaker Nancy Pelosi, D-Calif., and Senate Democratic Leader Charles E. Schumer, D-N.Y., said Sunday they will push for “cost-free testing” for all Americans, patient reimbursement for “any noncovered coronavirus-related costs” and protections “from price gouging of medical and non-medical essentials during this emergency.”
Schumer announced last week that he will advocate for legislation to make sure the coronavirus vaccine is also covered by Medicare and free for eligible seniors.
Insurance issues are often contentious in Connecticut, a center of the industry, as lawmakers push for more coverage at lower cost to consumers and the companies sometimes push back. Aetna, part of Rhode Islandbased CVS Health, has its insurance and health management headquarters in Hartford and Cigna, founded as Connecticut General in Hartford, is in Bloomfield.
The insurance industry contributes $13.9 billion to the state’s gross domestic product, about 5 percent of the state’s total activity. Nearly 3 percent of all working people worked directly in insurance in 2018, the highest percentage of any state, according to the 2018 Connecticut Insurance Market Brief, prepared by PwC and Connecticut Insurance & Financial Services, an economic development group.