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The Supreme Court ruled Monday that the federal government must live up to its promise to shield insurance companies from some of the risks they took in participating in the health law exchanges. Insurers who accused the government of a “bait and switch” claimed they are owed $12 billion.
“I think it’s fair to say that hospitals are facing perhaps the greatest challenge that they have ever faced in their history,” says Rick Pollack, president and CEO of the American Hospital Association. Federal aid is being distributed to help needy health system, but some wonder if it will be enough. Meanwhile, some hospitals start inching toward resuming non-coronavirus procedures.
HHS Secretary Alex Azar Azar declined to specify how much money would be allotted to help hospitals providing uncompensated care for COVID-19 cases. Meanwhile, CMS warns that COVID-19 treatment could cause Medicare reserves to run out and Medicaid waivers are approved to help deal with costs.
Delays in guidance from the Trump administration about how to pay for COVID-19 care have patients and hospitals worried about being on the hook for potentially massive costs. Meanwhile, workers who lost jobs because of the pandemic struggle to find affordable coverage.
The report from one of the nation’s major insurers reveals the complicated impact that the coronavirus is having on the health system.
During President Donald Trump’s tenure, his administration has chipped away at the health law and attempted to make moves on transparency and drug costs. But his legacy might be expanded federal health spending that looks a lot like his political foes’ dreams. Meanwhile, Politico looks at what the president said he’d do and what he’s actually done during the pandemic.
The Trump administration seems to be doing little to let Americans know they can sign up for health insurance through the exchanges if they lost their jobs because of the pandemic. Meanwhile, some states take steps to help people get on Medicaid during this tumultuous time. But in states where the program hasn’t been extended, Americans are struggling.
The stimulus bill includes $100 billion for the health care system to use to treat coronavirus patients, and the White House said hospitals that accept the grants will have to certify that they won’t try to collect more money than the patient would have otherwise owed if the medical attention had been provided in network. Meanwhile, lawmakers may use the next stimulus package to help address the broader issue of surprise medical bills. News outlets report on other insurance coverage and Medicaid developments, as well.
Supporters of “Medicare for All,” Sen. Bernie Sanders’ (I-Vt.) health care plan, are now more pessimistic than ever that the legislation would have a shot at getting passed. Sanders’ decision to end his campaign leaves former Vice President Joe Biden as the presumptive Democratic nominee. Meanwhile, Republicans launch an aggressive attack against mail-in-voting even as the pandemic rages on.
Eli Lilly said that during these tough financial times it would lower costs for anyone with commercial insurance or with no insurance at all. While some advocates cheer the decision, others wonder why the drugmaker had taken steps to cut costs now when diabetic Americans were rationing their supplies even before the pandemic.
Advocates are calling for the Trump administration to ramp up spending on outreach to make sure Americans who have been laid off during the crisis know there’s an option out there for them. The administration instead seems to be focused on a plan to tap hospital stimulus funds to pay people’s bills if they get coronavirus and need treatment
A pandemic-created recession is expected to test the health law like it’s never been tested before. Meanwhile, President Donald Trump’s decision not to create a special enrollment session surprised even his own advisers.
As unemployment surges, Medicaid will likely see a reflective wave of new enrollees. But hefty investments into the program will be needed to absorb those extra costs. “You definitely see in the data that as unemployment goes up, the Medicaid rolls go up,” said Josh Bivens, of the Economic Policy Institute. “That’s good, and it’s supposed to happen: It’s a safety net. But this is a quick enough shock that it could be a huge financial burden on Medicaid systems across the states.”
When President Donald Trump was asked what people should do who lose their jobs because of the outbreak and don’t qualify for Medicaid, he said, “I think it’s a very fair question . . . and it’s something that we’re really going to look at because it doesn’t seem fair.” Earlier in the week, administration officials said they would not launch a special enrollment session. Meanwhile, data released from last year’s health law enrollment for show about 11.4 million consumers signed-up for 2020 exchange coverage.
Facing the looming surge of coronavirus patients, some states have re-opened their marketplaces for residents to sign up for insurance coverage under the health law. Although the Trump administration considered following suit, it has decided to pursue other options.
Depending on how many people need care, insurers, employers and individuals could face anywhere from $34 billion to $251 billion in additional expenses. “No insurer, no state, planned and put money away for something of this significance,” said Peter Lee, the executive director of Covered California. Meanwhile, two major health insurers say they will waive out-of-pocket costs for coronavirus treatment.
Congress mandated that all testing for the virus should be free, but insurers can still bill patients for cost of care. Meanwhile, some states are moving to give uninsured residents a chance to sign up for their exchanges, while others ban insurers from canceling policies amid the crisis.
Read about the biggest pharmaceutical development and pricing stories from the past week in KHN’s Prescription Drug Watch roundup.
Community health centers face dwindling equipment and resources as they try to care for uninsured Americans amidst the COVID-19 emergency. And there’s an added stress for these facilities because their federal funding will run out in May. Meanwhile, how insurance will cover coronavirus testing and treatment remains an open question.
The legislation will include measures to boost paid family leave and unemployment insurance, ensure free coronavirus testing, and strengthen nutritional aid like food stamps. The final sticking points between House Democrats and Treasury Secretary Steve Mnuchin, the administration’s point person on the deal, involved paid sick leave. The House is expected to vote on Friday, and Senate Majority Leader Mitch McConnell (R-Ky.) canceled the Senate’s weeklong recess next week to assess the legislation.