Healthcare Coverage During the COVID-19 Crisis and Beyond

Healthcare is a human right. Everyone deserves access to affordable, comprehensive healthcare no matter their income, race, ethnicity, gender, or where they’re from. Yet the coronavirus pandemic has laid bare historic racial, ethnic, and income inequities in access to health care.

Data show that Black Americans are contracting and dying from the virus at disproportionately higher rates than others. Undocumented immigrants—millions of whom are serving on the frontlines as “essential workers”—cannot seek care for fear of deportation. And the high cost of testing and treatment remains a barrier for millions of uninsured people.

We can’t continue to accept these healthcare disparities as normal. Now is the time to create and implement solutions that not only address the immediate crisis but also begin to reduce those inequities and create healthier and more equitable communities.

Here are six steps the federal government can take now to create more equitable healthcare coverage and access:

1. The Trump Administration should immediately enact a Special Enrollment Period (SEP) so that people can enroll in comprehensive coverage through the federal health insurance Marketplace (HealthCare.gov) regardless of whether they have recently lost job-related coverage. Most state marketplaces have already opened for special enrollment in light of the COVID-19 crisis. An estimated 9.2 million workers have lost their employer-provided coverage since the crisis began.
   
   
2. Cost of coverage remains a barrier for many people, and even those who have coverage will be reluctant to seek testing and care, if they face a prohibitive cost-sharing burden. The federal government should temporarily boost advanced premium tax credits (APTC) for all eligible to no less than the lowest cost Bronze plan for the remainder of the calendar year.
   
   
3. Congress and the Administration should assure the states that the federal government will reimburse them for COVID-19 testing, treatment and related services (including a vaccination when available) for all uninsured individuals—including immigrant and undocumented populations.
   
   
4. Congress should require all plans to guarantee coverage for all medically necessary care related to suspected COVID-19. Related preventive and diagnostic services must be covered with no cost-sharing. Plans must cover services regardless of whether covered services are obtained from in-network providers, with payment at the plan’s median in-network rate for out-of-network care, and regardless of whether the patient receives a COVID-19 test or whether the test is negative, and providers should not be allowed to balance bill for these services.
   
   
5. Congress should provide substantially more fiscal relief to the states to better avert the looming budget shortfalls that states will face. Federal relief can help to ensure that  no eligibility cuts in Medicaid or healthcare coverage are necessary. 
   
   
6. Congress and the Administration should provide further increases in Medicaid funding to states through matching funds paid according to the Federal Medical Assistance Percentages (FMAP). Moreover, FMAP increases should be tied to increases in state unemployment rates so those increases do not stop when the Administration ends the national declaration of emergency but rather continue to help states that experience continuing economic hardship.