The Unfortunate Irony Of COVID-19 And Health Insurance — And Lessons To Learn From It

By Kayla Matthews, Productivity Bytes

Concerned people often bring up the need to reform the American healthcare system. Individuals who are lucky enough to have insurance may find their plan has so many stipulations that it doesn't provide the level of coverage originally anticipated.

A related issue is that the costs are often so high that people must choose between having it and putting food on the table. They go without coverage while hoping not to become ill.

There is also an ironic link between COVID-19 and health insurance. Many people get coverage through their jobs. Since the coronavirus caused widespread layoffs, individuals could find themselves without work, plus lacking insurance when they need it most.

Researchers Investigate The Damage

A team at the Kaiser Family Foundation found that 26.8 million individuals lost employer-sponsored insurance (ESI) due to the coronavirus. One of the positive estimates in the KFF report said that 19 million of them could switch to coverage offered by a spouse or parent's plan after losing their own.

The researchers point out that the Affordable Care Act and Medicare may provide some relief for newly uninsured people. However, they mention that getting coverage through those outlets may be out of someone's budget, or they may not know the options exist.

Coverage in The Lancet Oncology also warned how people in the American healthcare system who lose their insurance while receiving cancer care could experience deadly consequences. Dire circumstances could also crop up for people who still have coverage but feel the effects of COVID-19 in other ways. The article cited research showing, for example, that interactions between oncologists and their patients went down during the pandemic.

A lesson learned here is that people in power need to become more aware of the less apparent ramifications of joblessness. A higher unemployment rate hurts the economy and makes it more difficult for individuals to receive medical assistance during illnesses or injuries.

Medicare Beneficiaries Enjoy Increased Telemedicine Access

In mid-March, the Trump administration expanded telemedicine offerings for people receiving Medicare for the span of the United States' public health emergency. The decision made individuals eligible regardless of their state of residence and without traveling to a facility. Before the change, a person in a rural area may need to go to a telehealth clinic in the nearest city.

Another change related to COVID-19 and health insurance gave people more choices about the approved devices for receiving telemedicine care. Those that did not have a computer could have their appointments via phone, for example. Those are positive changes, but another crucial thing to remember about virtual visits overall is that it allows people to receive medical assistance without putting fellow patients or their providers at risk.

Telemedicine visits cannot replace every medical appointment. However, they can keep patients and providers connected and help them get the attention that may otherwise prove inaccessible due to the coronavirus. Having a compromised immune system or other health issues makes people avoid spending time in public while COVID-19 remains a threat. Other individuals appreciate telemedicine if they don't have cars or can't take time off from work.

Uninsured people may assume they can't get telemedicine or resist even investigating the option if they can't see up-front costs before booking an appointment. A valuable lesson, then, is for providers to spread the word about perks like transparent costs and flat rates for people who lack coverage.

Coverage And Costs Vary By Location And Provider

A historical trend in the health insurance sector concerns how an insured person's location affects their experience. In 2016, a decrease in enrollment numbers impacted the dominant insurer in Western Pennsylvania. Highmark accounted for about 28 percent of the region's health market, a drop from the 60 percent it held five years earlier.

That example shows how market shakeups happen relatively quickly. Such events typically help consumers due to increased competition. As the available options go up, individuals often see lower prices and special offers intended to boost business from new customers. That doesn't mean the health insurance system is necessarily easy to navigate, however.

One challenge is that the fears about the total cost for care may prevent both insured and uninsured people from seeking medical help. For example, the U.S. government made coronavirus tests free for all Americans — even those without insurance. That's a start, but it doesn't account for the anxiety that people understandably feel about how they'll manage the medical bills stemming from a positive test result.

Massachusetts and Michigan are among the few states that approved legislation to cover a patient's COVID-19-related treatment costs, as well as their copays and deductibles. Some insurers also made similar decisions. Even so, many people in the American healthcare system find themselves facing a situation where they must live in the "right" state or have coverage from the "right" company to avoid getting swamped with bills.

The main takeaway from this scenario is that lawmakers should examine ways to offer support for medical care associated with a health crisis rather than just the test to diagnose the issue. A recent poll found that one in seven Americans would not seek a doctor's care for symptoms associated with the coronavirus due to fears over the expenses. Such concerns are justified but could ultimately worsen and prolong the health crisis.

Health Insurance System Challenges In A Stress-Filled Time

Many people continually worry about getting sick while uninsured or finding they can't afford the bills even with coverage. Those anxieties rise in the middle of a global pandemic.

The issues mentioned here are not solvable overnight, but broadening awareness of the links between COVID-19 and health insurance that otherwise go unnoticed is crucial for meaningful change.

About The Author

Kayla Matthews is a MedTech writer whose work has appeared on HIT Consultant, Medical Economics, and HITECH Answers, among other industry publications. To read more from Kayla, please connect with her on LinkedIn, or visit her tech blog at https://productivitybytes.com.