Democrats ask Trump administration to make insurers pay for back-to-work COVID tests

Democratic leaders of House and Senate health-related committees on Tuesday asked the Trump administration to revise guidance that would exempt insurers from paying for COVID-19 testing employees return to work.

The Families First Coronavirus Response Act requires insurers to cover COVID-19 tests without patient cost-sharing, but the guidance, issued June 23 and first reported by Modern Healthcare, says that the law only applies to tests that are deemed “medically appropriate” by a healthcare provider.

That interpretation is in “violation of Congress’ clear legislative intent,” the Democrats wrote, adding, “With COVID-19 cases skyrocketing and our testing capacity nowhere near where it needs to be, it is unacceptable that this Administration’s priority seems to be giving insurance companies loopholes instead of getting people the free testing they need.”

The letter was signed by House Energy & Commerce Chair Frank Pallone (D-N.J.), House Education & Labor Committee Chair Bobby Scott (D-Va.), House Ways & Means Committee Chair Richard Neal (D-Mass.), Senate health committee ranking member Patty Murray (D-Wash.), and Senate Finance ranking member Ron Wyden (D-Ore.).

The lawmakers argue that the statute doesn’t allow the Trump administration to create limitations or conditions on which COVID-19 tests insurers are required to cover.

America’s Health Insurance Plans said testing for public and occupational health services should be supported by more government funds. The lobbying group commissioned a study in early June suggesting that diagnostic testing could cost the U.S. between $6 billion and $25 billion annually, and antibody testing could cost $5 billion to $19 billion.

Nursing homes will be among the employers most impacted by the Trump administration’s guidance. Some states require the facilities to test employees regularly and CMS recommends weekly testing. American Health Care Association/National Center for Assisted Living estimated that testing all employees of nursing homes and assisted living facilities once would cost $672 million.

The gray area in who should pay for the tests could leave workers vulnerable. A recent data analysis authored by long-term care workforce researcher Kezia Scales found that in 2017 84% of nursing home workers are female, and the majority identified as Black or Hispanic/Latino. Minorities have among the highest COVID-19 hospitalization rates, according to the Centers for Disease Control and Prevention.

Consumer advocates have voiced concern that the Trump administration’s guidance could create confusion about who is eligible for free tests, which could discourage people from getting tested.

Lawmakers are beginning to work on another COVID-19 relief package this week, as enhanced unemployment benefits expire at the end of July.

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