Patients Could Still Be on the Hook for Outpatient Costs, Costs If They Test Negative, and Cost Sharing
A new KFF analysis estimates that between 670,000 and 2 million uninsured people around the country eventually could be hospitalized with COVID-19, the respiratory disease caused by the novel coronavirus. Reimbursing hospitals for those treatments could cost between $13.9 billion and $41.8 billion.
Trump administration has indicated that it plans to reimburse hospitals for the care of uninsured COVID-19 patients through the $100 billion fund authorized by Congress for hospitals and other health care entities as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act. Reimbursing hospitals for these costs would consume as little as 14% to more than 40% of the special fund, according to the KFF analysis. There is a wide range of uncertainty surrounding the estimates, driven by uncertainty around what share of the population will ultimately become infected.
“Covering COVID-19 hospital costs for patients who are uninsured would give them peace of mind that their inpatient costs will be covered,” KFF President and CEO Drew Altman said. “While the details are spotty, uninsured patients could still be on the hook if they test negative for coronavirus and if they receive care outside hospitals.”
The estimates are based on existing data and information about the coronavirus’s anticipated spread, how often it leads to hospitalization, the number of uninsured people, and Medicare payment rates for respiratory infections and inflammations and respiratory illnesses requiring ventilator support.
The analysis highlights outstanding questions about how the federal government will help offset the bills that uninsured patients could receive, including whether the federal government reimburses physicians who treat uninsured COVID-19 patients in hospitals and treatment for patients with conditions that resemble COVID-19 who ultimately test negative for coronavirus. The policy also would not protect privately insured patients from cost-sharing and balance billing from hospitals and providers.