KFF: Most insurers phasing out cost-sharing waivers for COVID-19 treatments

Most insurers are no longer waiving cost sharing for COVID-19 treatments as healthcare use rebounded from lows exacerbated by the pandemic, a new analysis found.

The analysis, released Thursday from the Kaiser Family Foundation, found 72% of large health plans are no longer providing cost-sharing waivers as of this month. Another 10% of plans expect to phase out the waivers by the end of October.

Insurers initially offered the waivers when getting high profits after the pandemic caused healthcare use to plummet. Insurance companies were also worried about a federal mandate for the plans to cover treatment costs, Kaiser said. The federal government already covers all COVID-19 treatment costs for uninsured patients.

“But as vaccines have become widely available to adults in the U.S. and health care utilization has rebounded more generally, health insurers may no longer face political or public relations pressure to continue waiving costs for COVID-19 treatment,” the analysis said. “As more waivers expire, more people hospitalized for COVID-19—the vast majority of whom are unvaccinated—will likely receive significant medical bills for their treatment.”

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Kaiser looked at data from 102 health plans and found that 73 are no longer offering the waivers.

“Of the 29 plans still waiving cost-sharing for COVID-19 treatment, 10 waivers are set to expire by the end of October,” the analysis found. “This includes waivers that tie to the end of the federal Public Health Emergency, which is currently set to expire on Oct. 17, 2021, though may be extended.”

Another 12 plans say their waivers expire by the end of the year. The plans represent 62% of the individual and group markets.

An earlier analysis from Kaiser found that large group enrollees hospitalized for pneumonia, which requires similar treatment costs to COVID-19, paid out an average $1,300 out-of-pocket.

“Although this is a large amount to most patients, and could be an incentive to get vaccinated, it still only represents a fraction of the cost born to society for these largely preventable hospitalizations,” the analysis said.

The decision by insurers comes as earnings for major insurers returned largely to normal in the second quarter after massive profits during the same period in 2020.