Insurers, States Move to Lower COVID-19 Costs

by Leslie Small

As the new coronavirus continues to spread throughout the world, the U.S. federal government, states and private health insurers have responded with a flurry of actions aimed at lowering cost barriers that could discourage people from getting tested or treated.

More than 40 different health insurers so far have stepped forward to unveil new coronavirus-related policies, according to a running list compiled by America's Health Insurance Plans. Many are waiving cost-sharing and prior-authorization requirements for members who need to get tested for the virus, and some of them are also waiving deductibles. Other measures include relaxing restrictions on telehealth and prescription refills, and opening emotional-support help lines.

At the state level, some governors are tapping their emergency-rulemaking powers to compel the commercial health plans they regulate — those that are fully insured — to eliminate cost sharing for coronavirus-related testing and services.

Both states and insurers, though, have limited ability to compel employers' self-funded health plans to alter their benefits. Such plans are primarily regulated at the federal level under the Employee Retirement Income Security Act.

"The evidence is very clear that deductibles and exposure to other forms of cost sharing do mean people will delay or forgo care out of fear that they're going to face high cost sharing," says Sabrina Corlette, a research professor at the Georgetown University Health Policy Institute's Center on Health Insurance Reforms. "So to the extent that insurers can reduce that fear or eliminate that fear, I think they should do that."

Still, Kathy Hempstead, a senior health care policy adviser at the Robert Wood Johnson Foundation, says the need for so many players to revise their policies "reflects how unfortunately complex and fragmented the whole health insurance system is."

"I would imagine…that people are trying to do the right thing in all the different markets, but does that mean that cost isn't a deterrent for some people? I mean, it still probably is," she says. "It just goes to show how much cost exposure there is for, obviously, uninsured people, but [also] for the majority of insured people."

From Health Plan Weekly