Aria Bendix
2021-08-21 - PwC
A year ago, around 88% of people enrolled in private health plans through their employers would have had their treatment costs waived had they gotten COVID-19.
That's according to an analysis from the Kaiser Family Foundation. But now, most people who get hospitalized with COVID-19 could wind up with a hefty bill. A new report from the same group found that among the two largest insurers in each US state, 72% no longer waive costs for COVID-19 treatment.
KFF calculated that the average patient hospitalized with pneumonia (which requires a similar treatment to COVID-19) winds up responsible for around $1,300 in out-of-pocket costs - assuming they have an employer-provided plan.
The US government requires private insurers to make COVID-19 tests and vaccines free to the public, but treatments were never part of that mandate. So some states - Massachusetts, New Mexico, Idaho, Michigan, Minnesota, and Rhode Island - enacted their own requirements that insurers waive out-of-pocket treatment costs.
But even in other states, private insurers have covered treatment costs during the pandemic for the most part - either as a courtesy to patients or a preemptive measure in case the federal government mandated it, KFF found.
Then in November, insurers started to change course. By April 2021, roughly half of the 102 large health plans that KFF examined had stopped waiving COVID-19 treatment costs. Now, just 29 of those plans are waiving costs. Ten of those waivers are set to expire by the end of October, and another 12 will likely expire by the end of 2021.
The analysis concluded that insurers "may no longer face political or public relations pressure to continue waiving costs for COVID-19 treatment" now that vaccines are widely available.
But COVID-19 hospitalizations are skyrocketing again in the US: On average, daily hospitalizations have risen seven-fold in the last two months, from around 1,600 per day to 11,700 per day. That's similar to levels recorded in February, before vaccines were widely available.
Hospitals are now approaching capacity in Kentucky, Louisiana, and Georgia, among several other states. Alabama has run out of ICU beds. Healthcare workers say they're delaying non-emergency surgeries and denying patient transfers. Some patients have had to wait hours to be admitted to the emergency room. If hospitals become completely full, doctors may have to start turning people away, in some cases determining who lives and who dies.
The Delta variant has made severe disease more likely for unvaccinated Americans, who represent the vast majority of COVID-19 hospitalizations. The KFF analysis found that COVID-19 hospitalizations among unvaccinated people cost the US health system $2.3 billion in June and July of this year alone.