The Trump administration issued policy guidance this week telling health insurance companies that they are not required by law to cover the Covid-19 tests employers may compel workers to undergo as a condition for returning to their jobs.
The announcement (pdf) Tuesday by the Departments of Treasury, Labor, and Health and Human Services alarmed healthcare advocates and lawmakers who warned the move gives profitable insurers a green light to push the costs of potentially expensive coronavirus screenings onto workers.
"Once again, the Trump administration is prioritizing corporate profits over people. I'm deeply concerned that this will disproportionately impact frontline workers."
—Rep. Frank Pallone Jr.
The Families First Coronavirus Response Act, a relief bill President Donald Trump signed into law in March, includes a provision (pdf) mandating that insurers and employer-provided plans cover "Covid-19 testing and related services without cost-sharing."
But the Trump administration says in its guidance that the law only requires insurers to cover "medically appropriate" coronavirus screenings, not tests "conducted to screen for general workplace health and safety (such as employee 'return to work' programs)."
Rep. Frank Pallone Jr. (D-N.J.) blasted the Trump administration's interpretation of the law as a violation of congressional intent and "a free handout to the insurance industry."
"Once again, the Trump administration is prioritizing corporate profits over people," Pallone tweeted Wednesday. "I'm deeply concerned that this will disproportionately impact frontline workers."
According to the Trump Administration, insurance company profits are more important than the lives of nursing home residents and workers. https://t.co/AmmE8pDegg
— SocialSecurityWorks (@SSWorks) June 24, 2020
In April, the Equal Employment Opportunity Commission—a federal agency tasked with enforcing anti-discrimination laws—said employers are legally permitted to force employees to take Covid-19 viral tests to determine whether it is safe for them to return to the workplace.
New York, New Jersey, and other states currently require nursing homes to test employees to prevent the spread of Covid-19 in their facilities, which have been devastating hot-spots for the virus.
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The New York Times reported earlier this month that some nursing homes say they can't afford to pay for the testing and have tried to bill insurance companies for the costs. But not all insurance companies have agreed to cover Covid-19 testing, leaving workers on the hook for the bill.
Shikilia Davis, a nursing home worker in Long Island, told the Times that she was sent home by her employer one day after she refused to hand over her insurance card before getting tested. Davis said she feared being hit with the costs because her insurer has declined to cover coronavirus screenings.
"This is a bill I do not want to get stuck with," said Davis. "I don't have money lying around."
Nursing homes will be stakeholders to watch with this guidance, as some states require them to repeatedly test workers. Nursing homes say they can't afford the testing, and now insurers don't have to cover it. More on this via @nytimes @katie_thomas https://t.co/HcrQZ1aFUL
— Rachel Cohrs (@rachelcohrs) June 24, 2020
As consumer advocacy group Public Citizen documented in a report last month, "the vast majority of the largest health insurers" in the U.S. have temporarily waived some costs for Covid-19 testing and treatment.
"But these fee waivers contain significant restrictions and most are set to expire long before the pandemic can reasonably be expected to end," the report noted.
"In some cases, the insurers' statements of testing-related benefits appear less sweeping than Congress required," the report continued. "Some of the insurers' statements only promise to cover testing-related costs through certain dates. Other statements suggest a more restrictive universe of covered tests than the legislation calls for. Meanwhile, most of do not clearly warn members that they might be subject to costs if they see out-of-network providers."
Public Citizen argued that the best way to ensure everyone is able to receive the Covid-19 testing and treatment they need is by implementing Medicare for All, which the group describes as "the most sensible way to untangle the thicket of our healthcare system, protect Americans from crushing costs, and create a healthier and more productive society."
"Under Medicare for All," the group said, "nobody would have to worry about falling through the cracks of a broken healthcare system and facing financial ruin."