By Anna Wilde Mathews 

States are moving to block insurers from charging members for coronavirus testing, putting pressure on the industry to ease costs that might discourage people from getting diagnosed and treated.

As Washington on Thursday became the latest state to require that insurers make the testing free for their customers, the industry began taking voluntary steps.

Cigna Corp. said that in its plans nationwide, it would waive consumers' out-of-pocket costs for lab tests to diagnose infection from the novel virus, treating the tests like other types of preventive care that are free to members. Though these tests are already free when performed by the Centers for Disease Control and Prevention, they are expected to be offered more broadly by commercial labs that could charge. Consumer advocates have raised concerns that people might delay or decline testing for fear of high costs.

Cigna said the free lab test setup will apply in its fully insured plans, including employer and individual coverage, Medicare Advantage and Medicaid. Self-insured employers will have the option to offer the tests free of charge to their workers.

"We will do everything we can to help contain this virus, remove barriers to testing and treatment, especially for seniors and people who are chronically ill, and give peace of mind to those we serve," said Cigna Chief Executive David M. Cordani.

The order from Washington state's insurance regulator was broader: Insurers must cover, without copayments or other cost-sharing for patients, a health-care provider visit and testing for any member who meets the CDC's guidelines for testing for the novel coronavirus.

The cost would also be paid by the plan upfront before the patient's deductible is applied. Washington's announcement follows similar actions in New York and Missouri. Both states' efforts applied not just to lab tests but also to doctor and emergency-room visits if the patient was coming in to be tested for the coronavirus.

America's Health Insurance Plans, a trade group representing health insurers, said its members want to ensure that consumers don't face barriers to testing or care, and will "take action to ease network, referral, and prior authorization requirements and/or waive patient cost sharing."

Other states are weighing similar moves. In Rhode Island, where at least two people have been confirmed infected, the state insurance regulator is considering whether to ask or potentially require insurers to waive cost-sharing for coronavirus testing, according to a spokesman. "We want to be sure we have an effective response," he said. The regulator is meeting with insurers Friday.

The states are taking action amid concerns that consumers, even those with insurance, might avoid getting tested or treated because they would face large out-of-pocket costs. In a poll in March of last year, the Kaiser Family Foundation found that more than half of U.S. adults said they or a family member had put off health care due to costs. Among those with insurance, 34% said it was difficult to pay the cost of their deductibles.

Washington's insurance regulator also told insurers that they must allow access to out-of-network health-care providers at in-network rates if members can't get testing and treatment for Covid-19, the respiratory illness associated with the coronavirus, from doctors and hospitals included in their plans.

However, the state orders waiving cost-sharing have limits. They focus on diagnosis, not treatment of Covid-19. While most people generally see mild effects, older people and those with underlying health conditions have in some cases needed extensive, and costly, hospital care.

Also, state insurance regulators only oversee certain types of coverage -- they don't generally regulate Medicare or self-insured plans, which most large employers have.

It is too early to determine the financial impact the moves to waive cost-sharing could have on insurers. But it might be blunted because the efforts are limited to testing and diagnosis, and because the state moves, which are only in a few places so far, don't apply to all coverage, said Deep Banerjee, an analyst with S&P Global Ratings. Still, "if the cost includes more visits to high-cost facilities, that could be impactful," he said.

It also remains to be seen if regulators can ease concerns when people are covered by skinny plans that might only pay out a limited amount or not cover certain types of care. Some short-term plans don't cover drugs, for instance, or might pay only a set fee toward hospital or other care, leaving a consumer to shoulder the rest of the cost.

Insurance regulators also don't have power over health-care sharing ministries, which are supposed to help their members share medical costs. These ministries, which have been growing their enrollment in recent years, aren't insurance and typically don't guarantee they will cover all types of expenses -- nor do they have regulatory requirements to stockpile financial reserves.

Write to Anna Wilde Mathews at anna.mathews@wsj.com

 

(END) Dow Jones Newswires

March 05, 2020 18:40 ET (23:40 GMT)

Copyright (c) 2020 Dow Jones & Company, Inc.
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