COVID hospitalization averages $ 20,000 – and insurers want the unvaccinated to pay

Hospital care for critically ill COVID-19 patients is costing the U.S. health care system billions of dollars. And with highly effective vaccines for preventing hospitalizations now widely and free of charge available to anyone over 12, insurers and some companies want the unvaccinated – who make up the vast majority of COVID-19 hospitalizations – to cover a greater portion of those costs.

In June and July alone, the estimated cost of caring for unvaccinated people hospitalized for preventable COVID-19 cases reached about $ 2.3 billion, according to recent analysis from the Peterson Center on Healthcare and the Kaiser. Family Foundation. The analysis estimated that during those two months, 113,000 unvaccinated people were hospitalized mainly for COVID-19 and that their infection would have been prevented through vaccination. They then multiplied that number by $ 20,000, a rough estimate of the average cost of hospital care for COVID-19 patients, bringing the total to $ 2.3 billion.

Waivers

Since then, hospitalizations have only skyrocketed. On the last day of July, the seven-day moving average of hospitalizations in the country was around 40,000. Now that average is nearly 86,000, according to the Centers for Disease Control and Prevention.

Of course, the overall costs of health care are never primarily borne by the sick. They are mainly covered by public programs financed by taxpayers and private insurance. Out of hospital bills of about $ 20,000, a patient can only pay about $ 1,300 in personal expenses, based on data on the cost of similar care for pneumonia cases.

But the unvaccinated people hospitalized with COVID-19 may not even have needed to pay for that, at least not until recently. About 88% of people enrolled in an individual or fully insured health plan had reimbursable expenses for COVID-19 treatment waived by their insurers at some point during the pandemic. Health insurers have ignored cost sharing for a number of reasons, including seeing profits skyrocket amid the pandemic as people postponed normal health expenses, like elective doctor visits, screenings and elective procedures. Insurers have also offered waivers for fear of possible federal mandates for cost-sharing waivers and public relations considerations.

Financial risk

But with highly effective vaccines now widely available at no additional cost, insurance companies don’t feel so generous anymore. In a separate analysis, Peterson-KFF looked at the two largest insurers in the 50 states, as well as the District of Columbia, with 102 total health plans that cover about 62% of people fully enrolled in health plans. Although all plans have waived cost sharing at some point during the pandemic, 72% of them (73 plans) have now reversed those waivers. Of the 29 plans still offering waivers, 10 are expected to end waivers by the end of October, and 12 more are expected to end them by the end of the year.

And health insurers aren’t the only ones sick of bearing the brunt of COVID care costs. In a note to employees on Wednesday, Delta Air Lines CEO Ed Bastian announced that in addition to mandatory interior masking and weekly COVID testing, unvaccinated workers will be required to pay an additional $ 200 each month, starting from November 1, in order to stay with the company. health care plan.

“The average hospital stay for COVID-19 cost Delta $ 50,000 per person,” Bastian wrote in the note. “This surcharge will be necessary to face the financial risk that the decision not to vaccinate poses to our company. In recent weeks since the rise of B.1.617.2 [delta] variant, all Delta [Air Lines] employees who have been hospitalized with COVID have not been fully immunized.

Bastion noted that as of Wednesday, 75 percent of Delta employees were vaccinated.