COVID-19 Update: Most Private Insurers No Longer Waiving Cost-Sharing for COVID-19 Treatment

On Tuesday, August 25, Arizona reported 2,595 new cases of COVID-19 and 38 new deaths related to COVID-19. Arizona is still behind the national average on vaccinations, with 47% of Arizonans fully vaccinated against COVID-19. The national rate is 51.7%.

This information comes from the New York Times’ Tracking Coronavirus in Arizona: Latest Map and Case Count.
As of press time, Wednesday August 25,  the ADHS COVID-19 data dashboard was down.

In a press conference Wednesday, Banner Health Chief Medical Officer Dr. Marjorie Bessel took the opportunity to offer qualitative suggestions for the public rather than offering hard numbers and data. Stressing the importance of vaccination against COVID-19, was paramount, as 93% of COVID-19 patients in Banner hospitals at this time are unvaccinated. She also noted that numbers in Arizona are greater than in Banner’s Northern Colorado locations, although case counts there are rising rapidly.

Valleywise Health also held a press conference, in which CMO Dr. Michael White spoke about an increase in patients admitted to the Valleywise Medical Center, with 47 patients hospitalized with symptoms related to COVID-19. Although the patient population is younger than prior waves, none of the patients admitted at this time are pediatric patients. Dr. White did note that all of the patients admitted to Valleywise on August 25 were not vaccinated.

Our team continues to be very resilient, being able to step up and care for these individuals, but we need to continue to send the message, we need to get folks vaccinated if they’re able to get vaccinated. And if you’re feeling ill, please stay home.

Valleywise and Banner are both experiencing difficulties due to the national nursing shortage, and Valleywise is currently short 22 nurses at the main hospital alone.

This is about average for us over the last week, which requires us to make accommodations, pull nursing staff from other locations to be able to meet the needs acutely.

Insurers No Longer Cost-Sharing

According to a study by Peterson-Kaiser Family Foundation’s Health System Tracker (HST), most private insurers are no longer cost-sharing COVID-19 treatment. The U.S. government pre-paid for vaccines and requires all private insurance to cover the full cost of testing and not charge patients for costs associated with vaccination, but it does not waive out-of-pocket charges for treatment. Until recently, 88% of people enrolled in private health plans had their out-of-pocket expenses waived for hospitalization.

According to HST, insurers were able to eliminate cost-sharing and see high profits due to an overall decreased use in medical care. While some insurers began phasing out COVID-19 treatment cost-sharing in November 2020, it accelerated as the vaccine became increasingly available. The study found that 72% of the two largest insurers in each state and the District of Columbia are no longer waiving costs and another 10% of plans are phasing out waivers by October.

According to Modern Healthcare, Minneapolis-based UCare will waive cost sharing through the end of the year. From a UCare statement:

We took this step to ensure the best possible health outcomes and help reduce the spread of COVID-19. We have a long-held commitment to removing barriers — including cost — to accessing the care our members need. This investment in our members’ health will save costs in the long run.

The American Hospital Association voiced concerns about the impact this could have on communities as they try to slow the spread of COVID-19:

We have been long concerned that some health plans have excessively high cost-sharing, which has resulted in some individuals forgoing or delaying necessary medical care. This avoidance of care can not only result in worse health outcomes for an individual, but it can also increase the spread of the virus across communities.

Around the Country

Daily COVID-19 cases in the U.S, have risen 29% in the past two weeks according to Becker’s Hospital Review. The largest 14-day changes have occurred in previously-stable rural states like South Dakota, that had a 352% increase to 27 cases per 100,000 and West Virginia, which has 52 cases per 100,000 for a 160% increase.

Arkansas ran out of intensive care unit (ICU) beds on Tuesday for the first time since the COVID-19 pandemic began. The Associated Press reports that it took hours for one hospital in southeast Arkansas to show availability following Governor Asa Hutchinson’s announcement that the state had met capacity. From Gov. Hutchinson:

Everyone should know the strain this puts on our hospitals and the need to get our vaccinations and how critical our bed space is.

The state of Montana has banned any vaccine requirements for employees, following announcements from large companies across the U.S. that will require employees to get vaccinated. The Montana legislature passed the law earlier this year, requiring vaccines as a condition for employment to be deemed “discrimination” and a violation of Montana’s human rights laws, according to U.S. News.