By Deborah Hammonds, J.D.
KFF estimates hospitals could spend between $13 and $41 billion to treat uninsured patients during COVID-19 epidemic.
The estimated cost for hospitals to treat uninsured patients during the COVID-19 epidemic could be more than $41 billion, according to the Kaiser Family Foundation (KFF). KFF reviewed multiple factors including an estimated number of people who become infected with the virus; how many of those infected will require hospitalization; how many will require intensive care; and how much hospitals have been paid for treating uninsured patients with similar conditions. After considering the factors, KFF estimated total payments to hospitals for treating uninsured patients could range from $13.9 to $41.8 billion. At the top end of the range, payments on behalf of the uninsured would consume more than 40 percent of the $100 billion fund Congress created to help hospitals and others respond to the COVID-19 epidemic.
Congress passed three COVID-19 stimulus bills to provide additional funding for hospitals and free coronavirus testing for the uninsured through Medicaid, however, few specifics on the new policy for covering COVID-19 treatment of uninsured patients have been released. The Trump administration has said that hospitals would get reimbursed at Medicare rates, which are substantially lower than prices paid by private insurers. The administration has not provided any cost estimates for this new policy, other than to say that the funding will come from the $100 billion in the CARES Act.
KFF noted that given the uncertainty of its estimates of the total funding that will be needed to reimburse hospitals, and the fact that infections may come in several waves over the next year, it is unclear whether the new fund will be able to cover the costs of the uninsured in addition to other needs, such as the purchase of medical supplies and the construction of temporary facilities. Depending on how the remaining funds are allocated, the Trump administration’s policy could lead to larger share of the $100 billion fund going to hospitals in states with higher uninsured rates that chose to not expand Medicaid while leaving less funding for hospitals in states with lower uninsured rates that did expand Medicaid.
KFF’s analysis did not take into account the likelihood that patients could also face substantial medical bills for outpatient care outside of hospitals, or the fact that this policy could encourage the uninsured to seek care in hospitals instead of lower-cost settings where the federal government will not be reimbursing for their care. The uninsured will also not be covered for needed follow-up care if that care is not provided in a hospital, and the Trump administration has not specified whether it will cover treatment costs for patients who seek care for symptoms that are typical of COVID-19 but ultimately test negative for the coronavirus. Also, it is unclear if the uninsured will still be required to pay cost sharing for their hospital care, although HHS Secretary Azar stated that hospitals receiving these funds will not be permitted to balance bill patients for the difference between Medicare reimbursement and the hospital’s charges.
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