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July 9, 2020

The federal government will pay COVID-19 bills for CT's uninsured, but do they know that?

Photo | UConn Health/Janine Gelineau UConn Health's Farmington campus.

The federal government is paying for all testing and medical bills, including  expensive stays in intensive care units, for Americans who lack health insurance and have contracted COVID-19 — an unprecedented move that was initially hailed by health care advocates.

But help for the uninsured through the new Provider Relief Fund, a $175 billion program funded by the CARES Act, is now getting mixed reviews.

One criticism is that some doctors and hospitals, as well as patients who could benefit from it, don’t know the program exists. The uninsured may also be unaware of another, new $1 billion federal program that pays doctors who perform coronavirus testing on those who lack health insurance.

In his contract-tracing work for the New London-based Ledge Light Health District, Dr. Victor Villagra of UConn’s Health Disparity Institute said he was asked for help from an uninsured, unemployed woman. She had tested tested positive for COVID-19 and asked him what she should do with a bill she received for an x-ray, a bill that in all likelihood should have been submitted to the Provider Relief Fund, he said.

Villagra said he was frustrated because it was difficult for him to find out who was responsible for the bill.

“It makes sense that we take care of everyone,” Villagra said. “But it should not be so difficult to do so. What should have happened is that there should have been an easy way for that bill to be paid.”

UConn Health said it has only submitted bills to the program for nine qualifying patients.

“The claims are relatively new and we have not received reimbursement yet,” said UConn spokeswoman Lauren Woods.

Another criticism of the program is that the federal government is using the Provider Relief Fund for other purposes – including billions of dollars for hospitals hard-hit by the pandemic — and has not been transparent about how much money has been allocated to pay for health care of the uninsured.

“The big question is how long it will last as far as available funding,” said Jennifer Tolbert, health policy expert at the Kaiser Family Foundation.

She also questions whether doctors know to enroll in the Provider Relief Fund program, which pays coronavirus-related  bills generated by the uninsured at Medicare rates.  And Tolbert said the uninsured may not know they can seek care for COVID-19 without the fear of incurring medical expenses they can’t afford.

“Are they seeking care or are the barriers they had in the past preventing them from seeking care?” she asked about the uninsured.

There’s also the chance that people who are uninsured and  seek medical help thinking they have contracted  COVID-19 will end up with a different diagnosis — and a bill.

Still, the Provider Relief Fund is unprecedented, even as health care advocates and health care providers don’t entirely know how it is impacting health care for the uninsured.

For years, Connecticut’s uninsured rate was about a little more than 5 percent of the population, a relatively low rate compared to most other states. However, the state’s Latinos are more than twice as likely to be uninsured as everyone else.

Health experts say the pandemic’s blow to jobs and the economy has pushed the state’s uninsured rate up, although a recent count has not been taken.

Some Connecticut residents who lost income or jobs were able to sign up for Medicaid coverage, known in the state as HUSKY. Access Health CT says there are more than 46,000 new signups for HUSKY since March and that, as of July 7, there were 773,565 Connecticut residents enrolled in that health-care program for low-income individuals and families.

Another 8,000 residents were able to sign up for private health insurance, and premiums in most cases were subsidized, through Access Health CT, the state’s Affordable Care marketplace.

But there are many people who can’t afford even a subsidized health plan and whose incomes aren’t low enough for HUSKY. And the state’s undocumented workers cannot sign up for either HUSKY or private insurance under the ACA.

Those undocumented immigrants, however, can get care for COVID-19 through the Provider Relief Fund.

Alok Bhatt, community defense coordinator for the Connecticut Immigrant Rights Alliance, said he thinks many immigrants are unaware they can go to a doctor or hospital without incurring a bill if they have tested positive for the coronavirus. And he said those who do know about the program may have other reasons to shun hospitals and doctors.

“A lot of people are afraid to access medical care right now,” he said.

Some are afraid they will be deported, or lose their chance at residency or citizenship because they would be considered a “public charge” if they access government services.

Bhatt said that’s the reason many immigrants do not use “emergency Medicaid,” a program that provides cost-free health care to the uninsured, including the undocumented, if they have a life-threatening illness.

“I’m not sure right now any state or federal program will help,” he said.
 

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