COVID-19, what could it cost you?

Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

As the nation continues to navigate the COVID-19 pandemic, another top-of-mind concern is the cost associated with both testing and treatment for the illness. Between the boldness of certain state officials relaxing restrictions and the rapid ascension of cases, exposure to COVID-19 will inevitably rise.

The reassuring news is that the majority of Americans diagnosed will be able to recover from home. But what if you’re among the 15 percent that will need hospitalization? This subset of the population will require the most acute care, including admission into an intensive care unit and use of a ventilator. Between testing and treatment, there are a lot of factors for the consumer and patient to consider—outright costs of care, as well as cost-sharing (co-pays, deductibles, out-of-network costs, and more)—we did some of the research below.

Testing

  • Affordable Care Act (ACA)-compliant Plans: Under the Families First Coronavirus Response Act, all comprehensive health plans (individual, employer-sponsored, or ACA marketplace plans), must cover testing for COVID-19 at 100 percent.
  • Medicare & Medicaid: Testing is covered at 100 percent for Medicare and Medicaid.
  • Uninsured: Testing will be covered at 100 percent by Medicaid, as mandated by the CARES Act.
  • Non-ACA-Compliant Plans: Testing coverage may vary for consumers with non-ACA-compliant plans (i.e., short-term plans), as these plans are not subject to the protections found in the ACA.

Apart from non-ACA plans, there’s testing done in an emergency room, urgent care, or physician’s office, and all that should be covered. In addition, the health plan cannot impose prior authorization or cost-sharing restrictions (i.e., copays, deductibles, coinsurance) on the patient. Of course, access to testing is currently limited to those with symptoms or those working in health care facilities or other consumer-facing businesses. There are still strict criteria established by the Centers for Disease Control and Prevention (CDC).[1]

Treatment

Newly passed emergency bills do not address coverage of treatment. The Kaiser Family Foundation estimates that out-of-pocket costs for COVID-19 treatment for someone insured on an employer-based health plan could run upwards of $10,000, provided that there are no complications. For patients that require more acute care, costs could reach $20,000.

ACA-Compliant Plans: Health plans are not required to fully cover the cost of positive tests. A majority of the treatments for COVID-19 under ACA-compliant plans will qualify as essential health benefits, and as such will be covered. However, every state defines its own criteria for essential health benefits, and it is possible that some treatments will not be covered, based on where you live. Furthermore, coverage may vary depending on the type of group health plan you have (large vs. small).

Cost-sharing will also likely be imposed. Marketplace plans are required to cap maximum out-of-pocket costs for services covered in-network. In 2020, the maximum out-of-pocket cap is $8,150, meaning that if your care is deemed medically necessary, your out-of-pocket costs should not exceed that amount. Some plans have offered to cover patient-cost sharing for out-of-network care for COVID-19 in the absence of in-network availability. As an emergency course of action, several health plans have waived out-of-pocket costs like copays and coinsurance associated with treatment for COVID-19. To see where your health plan stands, click here.

Medicare and Medicaid: Medicare Part A (hospital stays) and Part B (doctor’s visits) will continue to charge copays and deductibles. The deductible for a 60-day hospital stay under Part A is $1,408. For Part B, the annual deductible is approximately $200. Cost-sharing related to Medicare Advantage and Medicaid plans will depend on your individual plan.

Uninsured: The Trump Administration has announced that part of the $100 billion of the $2 trillion appropriated for COVID-19-related relief in the CARES Act will be dedicated to reimbursing providers who treat uninsured patients. Provisions within the law include treatment for primary diagnosis of COVID-19 in a variety of settings, both emergency and non-emergency transportation, and post-acute care. Services that will be excluded from coverage include hospice and outpatient prescription drugs.

While further guidance is pending, Health and Human Services Secretary Alex Azar has clarified the following: “as a condition of receiving funds under this program, providers will be forbidden from balance billing the uninsured for the cost of their care.” This caveat reinforces that providers would get reimbursed at Medicare rates for delivery of uncompensated care and cannot balance bill the difference between Medicare reimbursement and the hospital’s charges.

In addition to the above, the law prohibits hospitals from charging patients beyond what they would pay in-network or what Medicare pays. The mandate against surprise billing serves to protect patients covered by government programs, employer-based plans, and self-purchased insurance.

Also, the growing loss of employer-based health coverage has prompted several states to extend their special enrollment periods to accommodate newly unemployed/uninsured patients during the pandemic. To see if you qualify for a special enrollment period, click here.

Non-ACA-Compliant Plans: Off-marketplace plans are not regulated by the ACA, and this could affect coverage for COVID-19-related treatment, where there is a possibility that treatment may not be covered outright. Examples of non-ACA plans include short-term health, fixed indemnity, and critical illness plans. These plans do not qualify for minimum essential coverage and are insufficient on their own, in our view.

Understanding insurance benefits can be daunting under ideal circumstances, let alone during a global health crisis. Consumers need enhanced accessibility and coverage now more than ever and NCL commends health plans for acting promptly to waive various cost-sharing measures. NCL urges Congress to continue to fortify and provide clear guidance for consumer protections, to ensure that they are not left stranded without vital care. Consumers, please know that there are COVID-19-related resources available to you—for more information, click here.

[1] To find a drive-thru testing site near you, click here.

Lessons from pandemic life: we all need the option of paper notice

Jim Haigh leads education and development efforts at Keep Me Posted North America, an advocacy organization focused on the mission of consumer choice in essential communications.

It was only last year that a whopping 86 percent of U.S. consumers expressed the desire of having a choice for how they receive important information from the companies they do business with. For critical correspondence such as bills and statements, the overwhelming majority want the option of paper or electronic delivery, and the ability to control their preferences.

But as consumers trapped in the digital divide have pleaded for communications choices and relief from punishing paper fees, more and more companies have prioritized digital-first approaches to conducting business including how they send legal notice of account, tacking on new charges along the way. It might have been easy for some demographics and geographic regions to overlook this important issue, having taken for granted the luxury, convenience and complacency of a digital world where everything always just works amazing in a click. 

But the calamities we are all seeing and experiencing—as new realities unfold have changed all of that. With government and company websites crashing, servers overloading, networks slowing, transactions halted, records quarantined, Americans—and the world—are waking up daily to a new appreciation of the need to have paper options. Failsafe analog backups, like physical bank records or medical histories, become a necessity as untold millions try to apply for emergency aid and assistance, complete their tax filings or take care of their health. Or cast their vote and complete the Census.

The digital divide has always been here, but too often hiding in plain sight. As schools across the country attempted to roll out remote learning, the widespread lack of access to affordable connectivity spanned from rural to urban to everywhere in between. The same widespread gaps true of home computers, tablets, and devices able to run the latest applications or function across important websites. The nation watched as people stood unsafely in lines to get paper forms because digital options foreclosed. With stores closed or stay-at-home ordered to populations, suddenly even basic supplies overlooked like ink, toner, batteries for devices and broken devices waiting for repair, all combine to give everyone an unwelcome taste of the great digital divide we all share.

Now that so many of us are on the same page, it’s a perfect time to highlight the efforts of the Keep Me Posted North America campaign to restore and sustain consumers’ choice in how they receive important information—on paper or electronically—from their service providers. National Consumers League is an active member of the non-profit KMP coalition of consumer groups, charities and businesses, and champions their mission and efforts to ensure that every consumer in North America has the option of both paper and digital communications—free of charge—from the companies they routinely do business with.

KMP’s advocacy, resources, and tools are crucial for all consumers to have the facts and a strong, united voice. It is up to all of us to build grassroots support and influence service providers directly. Together, we are making a difference.

Please join with KMP in urging banks, utilities, telecommunications, and all recurring service providers to take action proactively to benefit customers now during the pandemic and beyond by adopting the Keep Me Posted Best Practices for communications choice in essential customer communications. Together we ask that they fully treat bills and statements as true notice of account. In so doing, they will transparently provide a range of paper and digital options, honor preferences, seek consent for changes, and pose no barriers for customers needing to switch back or forth from digital to paper notice—without any additional fees charged for either form of delivery. 

Let’s all help companies understand the bargain: for less than seventy cents per account per month, customers will have the unfettered access to all the account information they need, how they need it, in whatever form they need it at their moment in this crisis we all share in together. And furthermore, empowering consumers with that flexibility of seamless access and delivery of paper and electronic account information will probably pay dividends as a sound investment—in customer retention, and measurable savings in customer service down the road.

About Keep Me Posted North America

Keep Me Posted advocates for the right of every consumer in North America to choose, free of charge, how they receive important information—on paper or electronically—from their service providers. KMP is a coalition of consumer groups, charities, and businesses that are committed to protecting consumer access to paper-based communications at no extra charge. These consumers include older adults, the disabled, low-income households without computers, printers or broadband service, and people in rural areas where unreliable internet access is common.

For more information on how to support KMP or to become a member, visit our website at keepmepostedna.org, or follow us on Twitter, Facebook, or LinkedIn.

 

New National Consumers League podcast We Can Do This! explores current, historic socioeconomic reform in America

January 16, 2020

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL), the nation’s pioneering worker and consumer advocacy organization, has launched a podcast called We Can Do This!, produced by District Productive and hosted by NCL Executive Director Sally Greenberg and other members of NCL policy staff. 

In We Can Do This!, NCL and justice-minded, expert guests explore current socioeconomic issues at the heart of American political and cultural battles before a backdrop of the historic and ongoing advocacy and activism that help pave the way for meaningful policy reform. 

We Can Do This! episodes span the breadth of NCL’s wide mission and issues, including; healthcare, data and privacy, food and nutrition, labor, finance, and other topics. 

A first batch of episodes featuring individuals who are helping to shape the nation’s social and economic reforms have been released:   

E1-2: Crashing through the glass ceiling with two dynamos of women’s rights law—parts 1-2 

With Judith Lichtman, president emeritus and senior advisor of the National Partnership for Women and Families and Marcia Greenberger, founder and co-president of the National Women’s Law Center 

E3: Ending the scourge of child labor 

With Kailash Satyarthi, anti-child labor crusader and Nobel Laureate 

E4: Measles, it ain’t over until it’s over 

With Dr. Linda Fu, general pediatrician at Children’s National Health System 

E5: Sorry, fair pay and a safe workplace aren’t on the menu 

With Diana Ramirez, federal senior policy advocate at Restaurant Opportunities Center (ROC United) 

These five episodes are available now on Apple Podcasts and Google Podcasts, and the remainder of the 11-episode series will be released in early 2020. 

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About the National Consumers League (NCL)

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

The National Consumers League mourns the untimely death of Congressman Elijah Cummings

October 17, 2019

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL) is saddened by the untimely death of statesman and U.S. Representative Elijah Cummings. Rep. Cummings was admired by friend and foe alike, an honest broker and legislative giant who chaired the House Oversight and Reform Committee and who never forgot his humble roots as the son of sharecroppers.

Rep. Cummings was in his 13th term serving as a representative of the Baltimore, MD community. As a member of the Maryland House of Delegates (1983 to 1996), he became the youngest chairman of the Legislative Black Caucus. Cummings campaigned tirelessly for stricter gun control laws and help for those addicted to drugs.  

Congressman Cummings often said that “our children are the living messages that we send to a future we will never see.” In that vein, he was committed to ensuring that the next generation has access to quality healthcare and education, clean air and water, and a strong economy defined by fiscal responsibility. 

He served as the Chairman of the Committee on Oversight and Reform, seeking to identify appropriate reforms that prevent waste, fraud, and abuse and that ensure government programs meet the needs of the American people. 

In recent months, Cummings had become a leader in President Trump’s impeachment inquiry: he didn’t hesitate to show anger, outrage, or disappointment in the actions and behavior of the administration officials. He strongly and vocally opposed the presidency of Donald Trump and was sued by President Trump in attempts to keep his business records secret. Most recently, Cummings was called upon to defend his constituents in Baltimore when President Trump made disparaging remarks about the city.  

“The whole nation will miss this remarkable man, who stood up to bullies, defended the rights of the less fortunate and underserved, but maintained his dignity and was always a gentleman and peacemaker—no matter what an opponent had to say about him and his district,” said NCL Executive Director Sally Greenberg.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

LifeSmarts launches 2019-20 season with new scholarship, community service opportunities for teens

September 18, 2019

Millions of student leaders have gained real-world knowledge through the program 

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC–Today marks the official launch of the 2019-2020 season of LifeSmarts, with a new competition going live at LifeSmarts.org. LifeSmarts, a program of the National Consumers League (NCL), is a national scholarship competition and educational program for middle-school and high-school students that tests knowledge of real-life consumer issues and is helping to create a future generation of consumer-savvy adults.

“We are very excited to launch this season of LifeSmarts,” said national Program Director Lisa Hertzberg. “For more than 25 years, LifeSmarts has given students the skills they need to succeed as adults. We’ve seen more than 1.5 million students gain knowledge, confidence, leadership capabilities, and team-building skills. The competition is fun, and the impact of LifeSmarts is life-long.”

LifeSmarts focuses on five main content areas:

  • consumer rights and responsibilities
  • personal finance
  • technology
  • health and safety
  • and the environment

Students are quizzed on their knowledge of these subject areas during online competition. Top-performing teams then advance to statewide competitions, and state champion teams as well as several wildcard teams advance to the national championship held each year in a different American city. The 2020 National LifeSmarts Championship will take place in the Washington, DC area April 25-28, 2020. Winning team members receive scholarships and other prizes.

Last year, students answered more than 3.5 million consumer questions about credit reports, recycling, nutrition, social media, state lemon laws, and everything in between. In April, the LifeSmarts state champion team from Barrington, Rhode Island, took home top honors at the 25th anniversary event in Orlando, Florida.

In addition to online, state, and national competitions, LifeSmarts recognition and awards occur throughout the program year:

  • Teams of students vie for cash prizes in the online TeamSmarts quiz, which focuses on a specific LifeSmarts content area each month from September through February.
  • Classroom mentor programs: Five $1,000 scholarships are awarded each winter to winning LifeSmarts students who become Safety Smart Ambassadors, using LifeSmarts content and UL’s Safety Smart modules to present safety messages to younger children in their communities.
  • Partnering with FBLA (Future Business Leaders of America), 4-H, and FCCLA (Family, Career, and Community Leaders of America), LifeSmarts complements these organizations’ projects, judging events, competitive events, and activities. LifeSmarts offers special opportunities for members of these student leadership organizations.
  • A new quest is open for middle school participants focusing on lithium ion button cell batteries and the risks and hazards they pose to young children. This team-building and leadership opportunity will culminate in a PSA contest among middle school LifeSmarts This project is sponsored by UL’s XPLORLABS, which helps students and teachers solve problems through science and engineering to become part of the movement to make the world a safer place.
  • Thanks to a long-standing partnership with Western Union, high school LifeSmarts participants have the opportunity to educate older citizens to avoid fraud. These LifeSmarts Fraud Ambassadors will highlight common advance-fee and fake check scams, demonstrating that education is the best protection against fraud.
  • A LifeSmarts student will win a $2,000 scholarship by writing the winning privacy essay in a contest sponsored by ITRC and CyberScout.

LifeSmarts is active in all states and the District of Columbia, where NCL is headquartered.

“We are proud of the impact LifeSmarts has made in its 25+ years of educating teens, and we are excited to continue to grow the LifeSmarts program, to educate students about financial literacy, and to create a new generation of savvy, market-ready consumers and workers,” said NCL Executive Director Sally Greenberg. “Too often traditional high school curriculum fails to teach students vital information that will be crucial once students go to college, get their first job, or move out of their parents’ house.”

In addition to hosting the official LifeSmarts competition, LifeSmarts.org provides resources for educators to supplement existing lesson plans. These include daily quizzes, educational videos, social media competitions, focused study guides, and scholarship opportunities. LifeSmarts lessons closely align with courses taught in family and consumer sciences, business, technology, health, and vocational education. Math and English teachers have also had success with LifeSmarts, as have homeschool and community educators.

Major LifeSmarts contributors include: Underwriters Laboratories (UL), Western Union, AARP, Comcast NBCUniversal, Sears Consumer Protection and Education Fund, American Express, Intuit, WSECU, CBM Credit Education Foundation, and a number of state and local sponsors.

Visit LifeSmarts.org for more information.

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About LifeSmarts

LifeSmarts is a program of the National Consumers League. State coordinators run the programs on a volunteer basis. For more information, visit: LifeSmarts.org, email lifesmarts@nclnet.org, or call the National Consumers League’s communications department at 202-835-3323.

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

NCL: Consumers should be able to access broadcast channels for free via Locast

August 5, 2019

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—Last week, the four largest broadcast networksABC, CBS, Fox, and NBCfiled suit against Locast, a free streaming service operated by the non-profit Sports Fans Coalition NY. The networks’ lawsuit seeks to block Locast’s streaming of local broadcast programming. The suit alleges that Locast violates copyright laws by failing to compensate the networks for their programming.

The following statement is attributable to NCL Vice President of Public Policy, Telecommunications, and Fraud John Breyault:

Consumers can already legally obtain free over-the-air broadcast channels via an antenna on their roofs. We think broadcasters would be better off embracing an innovative technology that allows consumers to more easily access their ad-supported content.

To secure public accessibility of broadcast signals, the Copyright Act expressly permits non-profit organizations to retransmit free over-the-air broadcasts. Locast is operated by the non-profit Sports Fans Coalition NY as a free public service. NCL supports broad consumer choice for access to local broadcast channels.

This year alone, the four largest broadcast networks are expected to generate more than $10 billion in retransmission-consent fees from cable and satellite providers that carry the networks’ programs. These fees are largely passed onto consumers in the form of higher monthly cable and satellite bills. Along with advertising that networks and local television stations sell, retransmission fees support the production of critically important local news content as well as traditional entertainment programming. 

NCL and Sports Fans Coalition (SFC) have a history of working together on a range of important consumer issues. In 2014, together we successfully petitioned the Federal Communications Commission to repeal the Sports Blackout Rule. In 2018, we jointly urged the Federal Trade Commission to protect consumers in the live event ticketing marketplace by cracking down on deceptive “white label ticketing websites.” We have also worked with SFC to create a landmark “Sports Bettor’s Bill of Rights” to ensure that consumers are protected as more states move to legalize online sports betting.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Being Financially Fragile in America – National Consumers League

By NCL Public Policy intern Melissa Cuddington

Nearly 36 percent of working Americans could not cover an unexpected $2,000 expense within 30 days. According to a survey done by the 2015 National Financial Capability Study (NFCS), working adults (ages 25 – 60) who answered “probably not” or “certainly could not” to the question of whether they could come up with $2,000 in 30 days. Such consumers are considered “financially fragile.”

The 2015 Survey for Household Economics and Decisionmaking (SHED) also revealed that 41 percent of respondents are considered financially fragile when faced with an emergency expense of $400. 41 percent said they would have to charge this unexpected expense to a credit card or use money from a savings account.

These statistics are not surprising considering that during the recession of 2008, nearly 50 percent of working adults were considered financially fragile.

Who is financially fragile?

  • Women (42 percent) are significantly more likely to be economically stressed than men (29 percent)
  • Financial fragility decreases steadily with increasing income, thus, paying workers more decreases their precarious finances
  • Financial fragility is about equally distributed across age groups, although fragility is slightly higher among 40- to 49-year-olds

According to a NEFE Digest article, a number of factors can cause financial fragility. A lack of assets include things such as low borrowing capacity on credit cards, inadequate health insurance, renting a house instead of owning and lack of access to traditional bank accounts. The second is debt, including medical, education and credit card debt. Some of these issues can be addressed with improved financial literacy.

The NCL is especially interested financial fragility in the U.S. for reasons that sync up perfectly with our mission: protecting workers and paying them a fair wage and ensuring consumer protections from predatory practices like payday loans and bank fees and excessively high interest on student or auto loans. We also agree with NEFE Digest that financial literacy reduces financial risk because consumers make better, more informed decisions when they have more knowledge and information. NEFE Digest notes that better financial literacy lowers one’s likelihood of being financially fragile–regardless of age or income.

Financially literate consumers bolster the overall health of the economy. This is why programs such as NCL’s LifeSmarts program, which educates youth the environment, health and safety, personal finance, technology and their rights as consumers, are so important. Financial literacy education should start young and continue throughout adulthood. Doing so reduces the risk to all consumers that they will become financially fragile.

BlackRock: Promoting shareholder activism – National Consumers League

By NCL Public Policy intern Melissa Cuddington

Many consumers think of money management companies, such as BlackRock Inc., Vanguard Group, and State Street Corp., to be solely interested in the finance market and ways to strengthen their investment portfolios. Turns out this isn’t entirely the case. 

The recent action of Laurence Fink, CEO of BlackRock Inc., calling on shareholders to better articulate long-term plans and spell out how their organizations can contribute to society in a positive manner, is a stellar example of a company promoting shareholder activism.

According to a Wall Street Journal article from earlier this year, Fink stated that BlackRock Inc. plans toover the next three yearsdouble the size of the team that engages with other companies regarding their societal impact. Fink also states that this team will be investigating corporate strategies that can be used when collaborating with investors and shareholders.

Fink states in his annual letter that investors must “understand the societal impact of your business, as well as the ways that broad structural trends—from slow wage growth to rising automation to climate change—affect your potential for growth.”

This statement by Fink caught NCL’s eye as a positive and productive move on the part of the finance industry. It is crucial that money management companies understand their societal impact and ways in which their investments affect structural trends—such as climate change and unemployment. We hope to see other money management companies follow suit.

Corner grocery stores: where convenience and junk food meet

Many of us take for granted the ability to make trips to a full size grocery store. For 23.5 million Americans, accessing a full-size supermarket is a challenge. In some areas, small corner stores are often the only source of food for underserved communities.