Back in April, the Trump administration announced it would require private health insurers to provide free antibody tests for coronavirus. "It is critical that Americans have peace of mind knowing that cost won't be a barrier to testing during this national public health emergency," said Seema Verma, director for the Centers for Medicare and Medicaid. Guess what? People are getting surprise bills for the coronavirus tests they're getting to protect themselves and their loved ones. Which kind of gives you a larger idea as to how seriously the Trump administration is taking your access to affordable health care, and what it would do should the Supreme Court strike the Affordable Care Act down. Nothing.
According to The New York Times' Sarah Kliff, the queen of the surprise billing beat among health care reporters, "about 2.4 percent of coronavirus tests billed to insurers leave the patient responsible for some portion of payment, according to the health data firm Castlight." Providers estimate that there have been 77 million tests done in the U.S. so far, which means hundreds of thousands of people are not getting the free testing promised by the administration.
“Whether it’s through legislative action or public statements, Congress has made it really clear that there shouldn’t be cost sharing for Covid-19 testing,” Julie Khani, president of the American Clinical Laboratory Association, told Kliff. “In practice, that’s not really the case.” The charges in some cases are violating the law, but those violations only count as far as there is an effort on the part of the government to enforce the law.
Kristine Grow, a spokeswoman for America’s Health Insurance Plans, provides an insight to how insurers are approaching this: passing the buck to providers. "If a claim is submitted with the proper coding to demonstrate that a test was given to diagnose Covid-19, or that a service was delivered to treat Covid-19, generally the claims for those tests and services are being covered at no cost to the patient." See, it's all about how the doctor or clinic or hospital providing the test coded it. It's all the fault of our complicated medical billing process and, you know, if there's a number wrong, what are they to do? They go after the patient.
Like Sarah Goldstone and Amanda Bowes and Kelly Daisley, who all talked to Kliff about how they were either informed by their insurers or saw ads talking about how testing is free. Daisley ended up being billed $2,718. “I had seen so many commercials saying there is testing everywhere, it’s free, you don’t need insurance,” said Ms. Daisley, 47, who was tested at an urgent care center three blocks from her Brooklyn apartment. “If I had to pay it off, it would clear out my savings.”
Here's what happened with her test, which was billed as two tests, diagnostic and for antibodies: "she logged into her health insurance portal and saw four claims associated with her tests: one for each test, one for the doctor visit, and one for other tests she didn’t realize were being ordered." Her insurance covered the cost of her walking into the clinic and of her diagnostic test—but paid nothing for the antibody test and other lab work because those were sent to a lab that was out-of-network. The law says that the antibody test has to be covered in full no matter which network does it.
Then there's just the larceny on the part of some of the testing providers, which of course don't have to worry about the Trump administration checking them. "Patients at a drive-through coronavirus testing site in Texas, for example, were unknowingly tested for sexually transmitted diseases." The insurance companies were, of course, billed for those tests and in many cases would pass the cost on to patients.
Daisley's tests ended up being covered by her insurer, Anthem, after Kliff started asking questions about it. “Seeing as Ms. Daisley was unaware the treating provider would send her samples to multiple out-of-network labs for what she understood was related to Covid testing, Anthem is covering the costs of the outstanding claims,” a spokeswoman for Anthem, Leslie Porras, said. Which is fine, but not everybody has access to a reporter to advocate for them.
There are loopholes in there that the Trump administration hasn't closed. As Kaiser Family Foundation reports, "there are limits to federal law coverage requirements that mean some patients with health coverage may nonetheless receive bills for COVID-19 diagnostic testing and related services, and those bills often can be widely different from patient to patient." Regulations from the administration could remedy that. If the administration cared.
Trump and his team clearly don't care. They've moved on from the pandemic and it is immaterial to them whether people come out of this alive and financially secure. It really doesn't matter to them. It really won't matter to them next year if the Supreme Court decides that Obamacare has to go.