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Emergency health care coverage for Covid-19 falls short of promise

August 31, 2020

Topics: Quote of the Day

Some patients are still receiving staggering bills. Others don’t qualify because conditions other than Covid-19 were their primary diagnosis.

By Abby Goodnough
The New York Times, August 29, 2020

A program Mr. Trump announced this spring… “should alleviate any concern uninsured Americans may have about seeking the coronavirus treatment,” Mr. Trump said in April about the program, which is supposed to cover testing and treatment for uninsured people with Covid-19, using money from the federal coronavirus relief package passed by Congress.

The program has drawn little attention since, but a review by The New York Times of payments made through it, as well as interviews with hospital executives, patients and health policy researchers who have examined the payments, suggest the quickly concocted plan has not lived up to its promise. It has caused confusion at participating hospitals, which in some cases have mistakenly billed patients who should be covered by it. Few patients seem to know the program exists, so they don’t question the charges. And some hospitals and other medical providers have chosen not to participate in the program, which bars them from seeking any payment from patients whose bills they submit to it.

Large numbers of patients have also been disqualified because Covid-19 has to be the primary diagnosis for a case to be covered (unless the patient is pregnant). Since hospitalized Covid patients often have other serious medical conditions, many have other primary diagnoses.

Critics say the stopgap program is among the strongest evidence that Mr. Trump and his party have no vision for improving health coverage, and instead promote piecemeal solutions, even in a national health crisis. Mr. Trump had promised a plan to replace the Affordable Care Act by the beginning of August, but none has been announced and he and other Republicans barely mentioned health policy in their national convention last week.

Unlike previous administrations during public health emergencies, Mr. Trump’s has not encouraged even temporary expansions of Medicaid — except for limited Covid testing — in states where the program covers few poor adults. It also declined to broadly reopen enrollment for Affordable Care Act plans once the pandemic began, although people who lose job-based coverage can enroll.

“This is not the way you deal with uninsured people during a public health emergency,” said Sara Rosenbaum, a professor of health law and policy at George Washington University.



By Don McCanne, M.D.

Even though the United States has the most expensive health care system of all, it still leaves tens of millions of individuals uninsured or underinsured. Because of the failure of our government to ensure adequate coverage for all, it became obvious that something was going to have to be done to cover the expenses of the victims of the Covid-19 pandemic without the means to pay for their care. To no surprise, trying to provide emergency patching of an inadequate health care financing infrastructure has fallen far short of the need.

If we had a single payer, improved Medicare for All program already in place, qualifying for health care would not have been an issue. The economic stress caused by the pandemic would still have to be managed, much as with other catastrophic events, but wouldn’t it have been so much better to have a fully functioning health care financing system already in place? Even with additional emergency financing, we are still leaving far too many out of the system. Besides, it would have been less expensive to do it right in the first place. Obviously, we can still fix it so this won’t happen again.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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