The health care industry wants the federal government to pay for mandatory quarantines of patients who may be carrying coronavirus but don’t need hospital care — a potentially high-dollar request for the emergency funding bill now under negotiation in Congress.
A growing number of Americans entered self-isolation over the weekend, including health care workers and other responders who’ve been exposed to the virus. This has only intensified the need for answers to a question hospitals flagged late last week, even as insurers grappled with the potential need to elaborate on their coverage policies.
The core issue is how to handle patients who are undergoing tests, or who’ve been diagnosed with coronavirus but are showing only mild symptoms, if any — yet who risk further spreading the virus to other members of their household if they isolate at home. Hospitals want the government to supply temporary facilities, such as hotel rooms.
One health care lobbyist framed the problem as one of potential bed shortages for the critically ill if the epidemic worsens, and patients who might otherwise go home have to stay in hospitals. In Washington state, where there are 14 confirmed cases of coronavirus in Seattle and King County, the county executive signed an emergency declaration that will allow the purchase of a motel as well as the setting up of modular housing units on publicly owned parking lots and other available land.
This pressure could further intensify if coronavirus snowballs in the U.S. as it has elsewhere in the world, where mass quarantines have become status quo.
There’s no word yet whether Congress will agree to include that language in the initial supplemental appropriations bill now under negotiation. Appropriators are still hammering out details of what’s now a $7 billion to $8 billion funding package to fight the coronavirus, but an individual familiar with talks said the text of legislation could come as soon as Tuesday. A vote on the package is expected in the House later this week, and the Senate will likely follow next week.
In a letter last week, the American Hospital Association formally asked Congress to, among other things, “provide housing, care and monitoring of patients” who don’t require hospitalization but need to be isolated. The ask was part of a $1 billion request for initial emergency funds. The American Nurses Association joined the petition.
“This includes persons with suspected or confirmed COVID-19 infections who experience mild to moderate symptoms,” the letter said.
Meanwhile, insurers are scrambling to come up with their own requests of the government.
So far the only public guidance on coronavirus from America’s Health Insurance Plans, the insurance industry’s main trade group, reiterates that testing for the disease should be free and conducted by the Centers for Disease Control and Prevention, and that plans cover “reasonable, medically necessary health care costs related to infectious diseases and medical conditions.”
Plans haven’t fully defined which aspects of treatment they deem medically necessary and therefore eligible for payment, saying it’s too early. A representative for AHIP said insurers are evaluating if they have to loosen policy restrictions for coverage related to the coronavirus.
Amid the funding talks, public concern over unexpected bills related to coronavirus treatment continues to mushroom.
And the question of who’s going to pay for any quarantines outside the home comes amid warnings that the U.S. health care affordability crisis could exacerbate the disease if people avoid testing or treatment over cost concerns. Democratic presidential hopeful Sen. Elizabeth Warren raised the alarm in a speech on Saturday.
“No one should face thousands of dollars in medical bills and lost wages if they’re put in mandatory quarantine by the government,” the Massachusetts senator said. “It’s not only the moral thing to do, it keeps us all safer.”
The Department of Health and Human Services and the CDC didn’t respond to requests for details on the administration’s plan for handling the quarantine matter.
The person familiar with talks in Congress confirmed lawmakers are working on one provision addressing cost concerns — a measure to guarantee affordability of any forthcoming vaccine for the virus.
The White House has fielded strong criticism from Democrats and Republicans alike over its reluctance to request more than its initial $2.5 billion plan focused mostly on early containment over long-term strategies.
HHS Secretary Alex Azar has defended the early request, saying $2.5 billion is meant to carry the country through Sept. 30, which marks the end of the current fiscal year, and that the administration will then work with Congress to expand funding for fiscal 2021. President Donald Trump has said he’s open to more funding.