U.S. Weighs Paying Hospitals for Treating Uninsured Virus Patients

Stephanie Armour

1 day ago

© Tom Brenner/Reuters

The Trump administration is considering using a national disaster program to pay hospitals and doctors for their care of uninsured people infected with the new coronavirus as concerns rise over costs of treating some of the 27 million Americans without health coverage, a person familiar with the conversations said.

In natural disasters such as hurricanes, hospitals and medical facilities can be reimbursed under a federal program that pays them about 110% of Medicare rates for treating patients such as those evacuated from hard-hit areas.

The Centers for Medicare and Medicaid Services has been in discussions about using that program to pay providers who treat uninsured patients with coronavirus, the person said.

Dr. Robert Kadlec, who is the assistant secretary for preparedness and response at the Department of Health and Human Services, also said Tuesday at a congressional hearing that discussions are being held about using the National Disaster Medical System reimbursement program. 

In 2018, 8.5% of people, or 27.5 million, didn’t have insurance at any point during the year. It was an increase from 2017, when 7.9% of the population, or 25.6 million, were uninsured, according to the U.S. Census Bureau.

About 2% of people infected with coronavirus have died and about 5% have developed serious infections that may require oxygen therapy or ventilators, based on research on cases in China.

In the U.S., there are more than 100 coronavirus cases. Anne Schuchat, principal deputy director of the U.S. Centers for Disease Control and Prevention, said at the congressional hearing Tuesday that “we are seeing community transmission in a few places.”

The administration is focusing on the costs of caring for uninsured people because individuals otherwise would have coverage through Medicaid, employers, or through private insurance purchased on the individual market, according to the person familiar with the conversations. No final decision has been made.

Hospitals, which typically bear the brunt of costs for uncompensated care, have been bracing for an influx of patients. Hospitals of all types provided more than $38 billion in uncompensated care in 2017, according to the American Hospital Association.

“We encourage the department to look at using a national disaster program as an option because no one should think twice about seeking screening or treatment due to costs,” said Tom Nickels, executive vice president of the American Hospital Association. “We also urge them to cover both patients who have coronavirus and those who are under investigation for coronavirus.”

A 1918-like pandemic would cause U.S. hospitals to absorb a net loss of $3.9 billion, or an average $784,592 per hospital, according to a 2007 report in the Journal of Health Care Finance that called on policy makers to consider contingencies to ensure hospitals don’t become insolvent as a result of a severe pandemic.

The National Disaster Medical System is subject to available funds and reimburses doctors and health facilities that provide care to eligible natural-disaster patients under specific guidelines if care isn’t available in their local area. It has been used in the past for situations such as Hurricane Irma in 2017, when about 85 patients were covered under the program.

Services that are covered include medically necessary hospital care, home health care, rehabilitation and primary care. More than 1,900 hospitals in the U.S. participate in the natural disaster care reimbursement program, according to HHS.

Write to Stephanie Armour at stephanie.armour@wsj.com