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Treating Uninsured Could Soak Up 40% of Hospital Virus Fund

April 7, 2020, 7:21 PM

The Trump administration’s plan to reimburse hospitals for treating uninsured patients with Covid-19 could consume more than 40% of the $100 billion fund Congress authorized to help hospitals, the Kaiser Family Foundation said Tuesday.

The KFF estimated that between 670,000 and 2 million uninsured people could require hospitalization, and reimbursing hospitals for their care could cost between $13.9 billion and $41.8 billion.

The report comes as the administration is under fire from Democrats and many health-care advocates for not reopening HealthCare.gov to get more uninsured people covered in the face of the pandemic. It is likely to spur more demands that the administration should take more aggressive steps to reduce the number of uninsured during the pandemic.

The Trump administration signaled last week that it won’t reopen widespread enrollment on the Obamacare exchange, which serves residents in 38 states. The other 12 states and the District of Columbia have their own exchanges, and all but Idaho have created new open enrollment periods during the pandemic.

Instead, the administration has said 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

Reimbursing hospitals for those costs would consume as little as 14% to more than 40% of the special fund, according to the foundation’s analysis.

The foundation acknowledged the wide range of its estimates. It said that is 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,” Drew Altman, the foundation’s president and CEO, said in a news release. “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.”

Many insurers have pledged that they won’t require their enrollees to pay any out-of-pocket costs associated with testing and treatment for Covid-19.

Over 20 Million Without Coverage

The Urban Institute estimated that, prior to the crisis, there were over 21 million people who were uninsured and ineligible for Medicaid but who didn’t live in one of the states or the District of Columbia that put a special open enrollment period in place for Obamacare.

Some would be eligible for premium tax credits subsidies, and some would also be eligible for reductions in their out-of-pocket costs, and some for unsubsidized coverage, Linda Blumberg, an institute fellow with the Urban institute, said in an email.

Of the 11.4 million people who enrolled during the normal open enrollment period for 2020, 8.3 million were in the 38 states that use HealthCare.gov, according to the Centers for Medicare & Medicaid Services.

To contact the reporter on this story: Sara Hansard in Washington at shansard@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Brent Bierman at bbierman@bloomberglaw.com

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