Charles Gaba's blog

I'm sure you've noticed that I've been posting more frequently about Michigan re. COVID-19 stuff than other states; there's a simple reason--my family and I live here. I'll still be posting major breaking developments for other states as well, of course, but I'm understandably more attuned to what's going on in my own state...

via Michigan Governor Gretchen Whitmer's office:

Whitmer Administration Expands Telemedicine, Urges President Trump to Permit ACA Special Enrollment Period During COVID-19

via the House Ways & Means Committee:

HOUSE DEMOCRATS INTRODUCE FAMILIES FIRST CORONAVIRUS RESPONSE ACT

  • Legislation provides paid leave, establishes free testing, protects health workers, and provides important benefits to children and families

WASHINGTON, DC — House Democrats today introduced the Families First Coronavirus Response Act to bolster the federal government’s response to the coronavirus outbreak and address the severe impacts of the coronavirus on Americans’ personal safety and financial security.

The Families First Coronavirus Response Act, expected to be considered in the House on Thursday, is sponsored by Appropriations Committee Chairwoman Nita M. Lowey (D-NY) and co-sponsored by Ways and Means Committee Chairman Richard E. Neal (D-MA), Education and Labor Committee Chairman Bobby Scott (D-VA), and Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ).

Last year, Maryland passed a very clever new law to help expand healthcare coverage through the state's ACA exchange and ACA Medicaid expansion without requiring any additional financial subsidies:

Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly.

The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state's Medicaid program or the health exchange, where individuals can buy health insurance plans.

...Dorn explained to me that the way it would work is much more than that: The state tax returns would include a new line where uninsured filers would be required to check off one of two boxes:

Two years ago, Democratic Congressmen Frank Pallone, Bobby Scott and Richard Neal introduced the awkwardly-titled "Undo Sabotage and Expand Affordability of Health Insurance Act of 2018", which really amounted to a suite of improvements and strengthening of the Affordable Care Act which I simply labelled "ACA 2.0".

At the time it was purely a messaging bill, of course, since the Democrats were in the minority in the House and Senate, as well as obviously not having control of the White House either.

Almost exactly a year later, the situation had changed: Democrats were still out of power in the White House and Senate, but they had flipped the House of Representatives on a promise of working to protect, repair and strengthen the ACA. Sure enough, the same ACA 2.0 bill was re-introduced with a few tweaks and a new, even clunkier name: The Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act.

As healthcare reporter Kimberly Leonard put it at the time:

BREAKING: The Centers for Medicare & Medicaid Services is allowing Medicare Advantage plans and Medicare drug plans to waive cost-sharing for #COVID2019 testing, treatments delivered by telehealth, prescription refill limits, among other things.
https://t.co/LXCyroChSU pic.twitter.com/0xhbeGButN

— Shira Stein (@shiramstein) March 11, 2020

Here's the full memo:

The Centers for Medicare & Medicaid Services (CMS) is issuing this information to Medicare Advantage Organizations and Part D Sponsors to inform them of the obligations and permissible flexibilities related to disasters and emergencies resulting from COVID-19.

Medicare Advantage Organizations

Special Requirements

via the Massachusetts Health Connector:

Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears

BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.

On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.

A few days ago, in light of HHS Secretary Alex Azar admitting that neither he nor anyone else at the HHS Dept. appears to have the slightest idea about how many Americans have actually been tested for coronavirus, I kiddingly mused:

Maybe I should register CoronaTestCount.net and start up an amateur spreadsheet to track this by state for the HHS Dept...hmmmm...

I was kidding, however, because my own plate is simply too full to take on that task as well.

Fortunately, I don't have to, because someone else has already stepped up to do exactly that. Via Josh Marshall of Talking Points Memo:

Well, this was inevitable:

Michigan announces first presumptive positive cases of COVID-19

Governor Whitmer declares a state of emergency to maximize efforts to slow the spread

LANSING, Mich. – Gov. Gretchen Whitmer, the Michigan Department of Health and Human Services (MDHHS) and the Oakland County Health Division and Wayne County Health Department announced today that two Michigan residents tested presumptive positive for coronavirus disease 2019 (COVID-19), the first confirmed cases in the state. The governor has declared a state of emergency to maximize efforts and assist local governments and officials to slow the spread of the virus.

"We are taking every step we can to mitigate the spread of the virus and keep Michiganders safe," said Governor Whitmer. "I have declared a state of emergency to harness all of our resources across state government to slow the spread of the virus and protect families. It’s crucial that all Michiganders continue to take preventative measures to lower their risk, and to share this information with their friends, family, and co-workers."

 

Here's the full transcript (verbatim) of Joe Biden's exchange with Lawrence O'Donnell about whether he'd veto some version of Medicare for All if it were to actually pass the House and Senate:

O'Donnell: "Let's flash forward: You're President, Bernie Sanders is still active in the Senate, he manages to get Medicare for All through the Senate; it's some compromise version, Elizabeth Warren's version or some other version...Nancy Pelosi gets a version of it through the House of Representatives; it comes to your desk. Do you veto it?"

Biden (after pausing to choose his words carefully): "I would veto anything that delays providing the security and the certainty of healthcare being available now. If they got that through and, some miracle, there was an epiphany that occurred, and some miracle occurred that said, 'it's passed', then you gotta look at the cost. I'd want to know how did they find the $35 trillion? What is that doing? Is it gonna significantly raise taxes on the middle class, which it will? What's gonna happen?

Washington becomes 1st state-based marketplace to create a special enrollment opportunity in wake of coronavirus threat. https://t.co/2bYCrboXvl @GtownCHIR

— Sabrina Corlette (@SabrinaCorlette) March 10, 2020

via the Washington Health Benefit Exchange:

Washington Healthplanfinder Announces Special Enrollment Period in Response to Growing Coronavirus Outbreak

 

Here's the full transcript verbatim:

"So, we've told you...we'll tell you what we know and don't know. So there's different types of tests which get sent out. The CDC's test that CDC is sending out, that's that 70...enough to send out 75,000 people, that was sent out last week. Those go to public health labs, about 80 labs in the United States, one in each state at least. Those report results back in to the CDC because they're part of the public health network. The larger quantity of tests that shipped, about 900,000 of the tests that shipped by this weekend, and then so many of the remainder of that 2 point...total, 2.1 million tests...those go to hospitals, private labs, others for testing...they don't currently have to report to us that they've conducted a test or what the result of that test is. The CDC is actively working right now to build that IT connectivity with them so we can gather that information. So right now...I could not give you a number of how many Americans have received a test because many will have received a test through hospitals or non-public health labs, and so...let's work with getting the system, the IT system up through the CDC, you want to get the accurate information as we go. 

Last week it was noted by several healthcare policy experts that if and when a vaccine for the coronavirus (COVID-19) sweeping the entire planet is ever developed, under the Affordable Care Act, insurance companies would be legally required to cover the full cost of it for anyone enrolled in an ACA-compliant policy:

SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.

(a) In General.--A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for--

(1) evidence-based items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force;

(2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved; and

via Connecticut Governor Ned Lamont:

Governor Lamont Announces First Positive Case of Novel Coronavirus Involving a Connecticut Resident

(HARTFORD, CT) – Governor Ned Lamont today announced that the Connecticut Department of Public Health (DPH) State Laboratory has confirmed the first presumptive positive case of coronavirus disease (COVID-19) involving a Connecticut resident. The patient, a resident of Wilton who is 40 to 50 years of age, is being treated at Danbury Hospital. The person most likely became infected with the virus that causes COVID-19 during a recent trip to California and sought medical care shortly after returning to Connecticut.

This presumptive COVID-19 case is not related to the COVID-19 case involving a Danbury Hospital employee who is a resident of New York State that was announced on Friday, or the COVID-19 case involving a community physician who made rounds at Bridgeport Hospital and is also a New York State resident that was announced on Saturday.

via David Eggert:

LANSING, Mich. (AP) — Michigan health insurers said Friday they will cover the cost of medically necessary tests for the new coronavirus for people covered under employer and individual health plans, while Gov. Gretchen Whitmer announced the waiving of testing and treatment fees for Medicaid recipients.

...Plans that will waive copays and deductibles for testing costs include Blue Cross Blue Shield of Michigan, Blue Care Network, Priority Health, CVS Health, McLaren and Meridian, according to the governor’s office. The change will not apply — for now — to large employers that self-insure but use insurance companies to administer their benefits.

...Blue Cross Blue Shield will forgo prior authorization rules for diagnostic tests and covered services to treat the disease, set aside refill limits on prescriptions, and expand access to telehealth and a 24-hour nurse hotline.

This just in from the Florida Insurance Dept:

TO ALL HEALTH INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS AUTHORIZED TO DO BUSINESS IN FLORIDA

~ INSURANCE COVERAGE FOR CORONAVIRUS (COVID-19) ~

In response to the Executive Order #2020-51 issued by Governor Ron DeSantis establishing COVID-19 response protocols and directing a public health emergency in Florida, the Florida Office of Insurance Regulation (OIR) is issuing this Informational Memorandum to all health insurers authorized to do business in Florida to help facilitate the state’s ongoing efforts to protect Floridians.

Heightened Communication and Customer Service

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