On this version
- Eight states + DC now provide particular enrollment intervals
- State actions require or encourage insurers to completely cowl testing
- State actions to enhance entry to telemedicine, together with waiving charges and stress-free rules
- New Mexico requires insurers to waive cost-sharing for COVID-19, flu, and pneumonia
- States cross laws to deal with COVID-19 pandemic
A lot of regular life in America has floor to a halt within the final week. Faculties and eating places have shut down in lots of areas, journey plans have been placed on maintain, and the official suggestion is for folks to remain dwelling if in any respect potential so as to sluggish the unfold of COVID-19.
Within the midst of all this uncertainty, there are widespread questions on medical health insurance protection for COVID-19. And other people with out well being protection are going through an much more perilous state of affairs than common.
Right here’s our have a look at what’s occurring on the state stage to deal with these points:
Eight states + DC now provide particular enrollment intervals
The record of state-run exchanges providing a particular enrollment interval to deal with the COVID-19 disaster continues to develop. As of Wednesday, seven state-run exchanges are providing SEPs straight triggered by the pandemic, and two others have ongoing SEPs for uninsured residents:
- Washington State (till April 8)
- Massachusetts (till April 25)
- Maryland (till April 15)
- Rhode Island (till April 15)
- New York (till April 15; SEP applies each on- and off-exchange.)
- Nevada (till April 15)
- Connecticut (begins March 19, ends April 2)
- California (till April 20; unrelated to COVID-19)
- District of Columbia (is determined by date tax return is filed; unrelated to COVID-19)
Colorado’s Division of Insurance coverage has revealed a draft proposal calling for a particular enrollment interval from March 20 by means of April 3 that will enable people who find themselves at the moment uninsured to enroll in a plan by means of the state-run change or straight by means of an insurer. The Division is accepting feedback on this proposal by means of March 19, so the small print might change earlier than it’s finalized.
State-run exchanges have the facility to concern their very own particular enrollment intervals, however solely DC and 12 states have totally state-run exchanges. Most states depend on the federally run HealthCare.gov as a substitute. The federal authorities has not but introduced a particular enrollment interval for HealthCare.gov, however its is going through growing calls to take action. The governors of Michigan, New Jersey, and Pennsylvania have requested the Division of Well being and Human Providers (HHS) to create a particular enrollment interval so as to scale back the variety of people who find themselves going through this pandemic with out well being protection.
We’re monitoring particular enrollment intervals associated to COVID-19 and we’ll proceed to replace the web page as extra info turns into obtainable, so you’ll be able to bookmark it for future reference.
State actions require or encourage insurers to completely cowl testing
Within the early hours of Saturday morning, the U.S. Home of Representatives handed H.R.6201, the Households First Coronavirus Response Act. If handed by the Senate and signed into legislation, the laws would require all well being plans, together with self-insured plans and grandfathered plans, to cowl the price of COVID-19 testing.
However in the meanwhile, states have been performing on their very own to manage the well being plans that fall below their jurisdiction. Notably, this doesn’t embody self-insured plans – the vast majority of staff who’ve employer-sponsored well being plans – as they’re regulated on the federal stage.
Final week, we shared a listing of states that had both directed or requested insurance coverage corporations to waive cost-sharing (the patron’s out-of-pocket prices) for COVID-19 testing. Many of the remainder of the states have now issued steerage both requiring or asking insurers to completely cowl the price of testing, or noting that insurers have voluntarily agreed to take action. Along with the states we talked about final week, the next states have lately issued steerage on this concern:
States requiring insurers to cowl testing with no cost-sharing:
- Alaska
- Maine
- New Hampshire
- Arizona
- Rhode Island
States asking insurers to cowl testing with no cost-sharing:
- Alabama
- Minnesota (The steerage asks insurers to completely cowl the price of testing and to “restrict or eradicate” the price of remedy. However it additionally notes that the Walz administration is asking lawmakers to step in to require this)
- Oklahoma
- Wyoming
- North Carolina (plus steerage to permit further prescription refills)
State the place insurers are voluntarily waiving cost-sharing for testing:
- Indiana
- Iowa
- Kansas
- Nebraska
- South Carolina
- Virginia
- Michigan
- Louisiana
- Pennsylvania
States increasing entry to telemedicine
A number of states have taken motion to make sure that telemedicine companies associated to COVID-19 can be found with no cost-sharing for folks enrolled in state-regulated plans. Different states are encouraging this method from their insurers, or have relaxed the foundations for telemedicine so as to develop entry. And nearly all states are encouraging insurers to evaluate their telehealth protocols to make sure that they’ve a strong system that may deal with the elevated demand this pandemic is prone to create. States are additionally encouraging insurers to tell members about telehealth choices and modify their applications to incentivize members to make use of telehealth each time potential, so as to keep away from spreading the virus to different sufferers at a physician’s workplace.
The next states are requiring state-regulated well being plans to cowl COVID-19 telehealth with no cost-sharing:
- Colorado
- Massachusetts
- New Mexico
- Rhode Island (telephone-only)
- Arizona is requiring insurers to supply telemedicine with decrease cost-sharing than in-person remedy, however it doesn’t must be free.
The next states are asking insurers to waive cost-sharing for telehealth, however have stopped wanting requiring it:
- Connecticut (inspired to waive)
- Oklahoma
- Texas
The next states have modified their guidelines regarding telehealth companies so as to make it simpler for medical professionals to supply telehealth care and for sufferers to entry it:
- Mississippi
- Delaware
- New Hampshire
- Michigan
- Texas
New Mexico requires insurers to waive cost-sharing for COVID-19, flu, and pneumonia
New Mexico has gone a step additional than most states, requiring insurers to cowl – with no cost-sharing – medical companies associated to COVID-19 in addition to influenza and pneumonia. The emergency rule – which shall be in impact for at the very least 60 however not more than 180 days – requires state-regulated insurers to cowl testing in addition to “supply of well being care companies” for these situations. (In most states, insurance coverage rules associated to COVID-19 require zero cost-sharing just for testing, and a few states additionally require zero cost-sharing for telemedicine associated to the illness.)
States cross laws to deal with COVID-19 pandemic
Lawmakers in a number of states are addressing the pandemic with various laws, a few of which straight pertains to well being protection, together with Medicaid. The Nationwide Convention of State Legislatures is a wonderful useful resource for protecting observe of those developments.
