Reps. Shalala and DeGette Introduce Lifesavings Legislation to make Coronavirus Tests Free for Most Americans

Statement

Today, U.S. Reps. Donna Shalala (FL-27) and Diana DeGette (CO-1) introduced the Covering Coronavirus Test Act of 2020, legislation that would require health insurers to cover the full cost of coronavirus tests for any American who has health insurance through their employer, or who has purchased a health plan through the ACA exchange.

Specifically, the legislation would add the coronavirus test to the Affordable Care Act's list of "preventive health services" that health insurers are required to cover at no cost to patients. Not only would the legislation require that health insurers provide coverage for the tests, it would also prevent them from passing on any portion of the cost to beneficiaries.

"Our government has a responsibility to do everything it can to manage this crisis," Shalala said. "One of the biggest barriers to addressing this emergency is figuring out how many people have been infected by COVID-19. By reassuring the public that they will not bear any out of pocket costs for testing for the virus, this bill will help us get true sense of the scale and rate of infection in the U.S. and allow the government to deploy the right measures to keep the American people safe."

"We are on the cusp of a worldwide pandemic," DeGette said. "In order to effectively curb the spread of this virus here in the U.S., we must increase testing immediately. No patient should hesitate getting a test done if a doctor thinks it's necessary because of the cost. This legislation will ensure that anyone who has health insurance through their employer, or through of the ACA exchanges, can get the test done at no cost to them."

Under the terms of the Affordable Care Act, private health insurers, and those who offer health care plans through one of the ACA exchanges, are required to cover the full cost of any "preventive health service" provided to their beneficiaries. The law specifies a list of such services that insurers must cover at no cost to patients -- such as annual flu shots and mammograms.

If approved, the legislation would ensure that the nearly 178 million Americans who currently have health insurance through their employer, and an additional 11 million Americans who purchased health insurance through the ACA exchange, can get tested for the virus at no cost to them, if the need were to arise.

To enable the legislation to take effect immediately upon being signed into law, the measure includes a provision that would exempt the coronavirus test from the one-year waiting period that new preventive health services must undergo before insurers are required to cover them under the ACA. Instead, the legislation would require that health insurers cover the full cost of any tests performed after the bill is enacted.

Medicare, which provides health care coverage for Americans 65 year of age and older, announced recently that it will cover the cost of any coronavirus test ordered by a physician.

The decision on whether to cover the cost of the test provided to patients on Medicaid, the government-run health care plan for low-income Americans, will be up to each individual state.

While the Centers for Medicare and Medicaid recently created a new billing code for hospitals to use to bill for the coronavirus tests, the agency has not yet set a price for the procedure.

The lawmakers said Tuesday that now that the measure has been introduced, they are working to have it included in any future coronavirus-related legislation Congress takes up in the coming weeks.

A copy of the legislation is available here.

Source