Insurers stop waiving COVID treatment costs as hospitalizations rise

• Many large insurers are no longer waiving COVID-19 treatment fees, new analysis shows.
• Insurers started charging again once vaccines became widely available.
• But hospitalizations are increasing in the United States. People hospitalized with COVID-19 can pay $ 1,300, on average.

A year ago, about 88% of people enrolled in private health plans through their employers would have had their treatment fees waived if they had contracted COVID-19.

This is according to an analysis by the Kaiser Family Foundation. But now, most people hospitalized with COVID-19 could end up with a hefty bill. A new report from the same group has found that among the two largest insurers in each U.S. state, 72% are no longer waiving COVID-19 treatment costs.

KFF has calculated that the average patient hospitalized with pneumonia (which requires treatment similar to COVID-19) is responsible for about $ 1,300 in out-of-pocket expenses – assuming they have a plan provided by the employer .

The U.S. government is demanding private insurers make COVID-19 tests and vaccines free to the public, but treatments have never been part of that mandate. For example, some states – Massachusetts, New Mexico, Idaho, Michigan, Minnesota, and Rhode Island – have adopted their own requirements that insurers waive reimbursable processing fees.

But even in other states, private insurers have mostly covered the costs of treatment during the pandemic – either as a courtesy to patients or as a preventative measure in case the federal government mandates it, KFF found.

Then in November, insurers started to change course. As of April 2021, about half of the 102 large health plans reviewed by KFF had stopped waiving COVID-19 treatment costs. Now only 29 of those plans are waiving costs. Ten of those waivers are expected to expire by the end of October, with a further 12 likely to expire by the end of 2021.

The analysis concluded that insurers “may no longer be under political or public relations pressure to continue to waive the costs of COVID-19 treatment” now that vaccines are widely available.

But COVID-19-related hospitalizations are skyrocketing again in the United States: On average, daily hospitalizations have increased sevenfold in the past two months, from about 1,600 per day to 11,700 per day. This is similar to the levels recorded in February, before vaccines became widely available.

Hospitals are now nearing maximum capacity in Kentucky, Louisiana and Georgia, among several other states. Alabama no longer has intensive care beds. Healthcare workers say they are delaying elective surgeries and refusing patient transfers. Some patients had to wait hours before being admitted to the emergency room. If hospitals become fully full, doctors may have to start turning people away, in some cases determining who lives and who dies.

The Delta variant has made severe illness more likely for unvaccinated Americans, who account for the vast majority of COVID-19-related hospitalizations. KFF analysis found that COVID-19-related hospitalizations among unvaccinated people cost the U.S. healthcare system $ 2.3 billion in June and July of this year alone.