- The American Hospital Association, America's Health Insurance Plans and the U.S. Chamber of Commerce, along with nearly 30 other organizations, are urging Congress to expand coverage options for those who've lost their jobs amid the COVID-19 pandemic, and for those in limbo facing furloughs or temporary layoffs.
- Relying on the $100 billion allocated to hospitals in the Coronavirus Aid, Relief, and Economic Security Act "will quickly deplete the Emergency Fund and not provide the benefits of comprehensive coverage," the groups wrote a Tuesday letter, and more targeted measures are needed.
- The powerful business lobbies detailed five steps for the next round of coronavirus relief legislation, including providing employers with temporary subsidies for keeping employees on their health plans. Other asks include covering the costs of coverage through COBRA, expanding the use of health savings accounts and opening a special enrollment period for the Affordable Care Act marketplaces.
The industry groups are pushing back against an HHS plan to pay for treatment of uninsured COVID-19 patients out of already allocated congressional funding in the CARES Act. A portal for providers to apply for those funds opened Monday, but the department has not said how much is earmarked for treating those without coverage.
The cost is likely to be substantial. A Kaiser Family Foundation study estimated hospital costs to treat the uninsured could top $40 billion — or about 40% of the CARES act funding.
"We really think that the emergency fund is not the type of place to provide this kind of important assistance," AHA CEO Rick Pollack said Tuesday on a call with reporters. "That emergency fund was really provided to help ensure the viability of hospital systems and our providers because we are going through unprecedented challenges."
An initial $30 billion round of CARES funding went out to providers based on Medicare payments and another $40 billion is slated to go out next, targeting providers in COVID-19 hot spots and rural facilities.
Last week another piece of funding was signed into law: The Paycheck Protection Program and Health Care Enhancement Act, giving hospitals an additional $75 billion in emergency funding and $25 billion to expand COVID-19 testing.
But the financial woes hospitals currently face would pale in comparison to the cost of treating a record number of unemployed, and uninsured Americans, the business groups in Tuesday's letter warned. Almost 27 million people in the U.S. have filed for unemployment in the past five weeks and the number is only expected to grow as many states continue shelter-in-place orders.
At the same time, hospitals' operating margins have plummeted due to large-scale volume and revenue declines coupled with flat to rising expenses, according to an analysis from Kaufman Hall. Some health systems have reported quarterly earnings, including UHS with operating income down 30%, and HCA with profit down 45%.
Other suggested steps to increase coverage options include expanding HSAs, which currently may only be used for certain qualifying expenses.
Also, increasing eligibility for federal subsidies for the ACA marketplaces for individuals and families that earned too much money to qualify for those subsidies but too little to afford premiums.
Finally, they suggest opening a special enrollment period for ACA coverage, which the Trump administration has declined to do during the ongoing pandemic.
All of the suggested measures would be temporary, the letter said, but are crucial to offsetting projected costs.
"No one's trying to rewrite long-term policy here, we're trying to address immediate need," said Neil Bradley, executive vice president and chief policy officer at the U.S. Chamber of Commerce. "As we've seen with a full host of other programs, it's important to leverage existing delivery mechanisms in order to provide what's needed in a timely fashion."