COVID-19, what could it cost you?

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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.

How do we deal with the ‘ticking time bomb’ in agriculture?

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Reid Maki is the director of child labor advocacy at the National Consumers League and he coordinates the Child Labor Coalition.

It’s been referred to as a “ticking time bomb,” the coronavirus and its potential impact on farmworkers—the incredibly hard-working men, women, and children who pick our fruits and vegetables and provide other vital agricultural work. Farmworkers perform dirty, back-breaking work, are notoriously underpaid for it, and now face great risk from COVID-19.

Farmworker advocacy groups that National Consumers League (NCL) works with or supports—such as Farmworker Justice, the Coalition of Immokalee Workers, the United Farmworkers of America (UFW), the Farm Labor Organizing Committee, and a national cadre of legal aid attorneys—have spent weeks strategizing about ways to protect the community they know is especially vulnerable to the virus.

Advocates have reached out to administration officials and Congress for desperately needed resources to support impoverished farmworkers with little to show for it. Despite their essential contributions to the economy, farmworkers have been cut out of the emergency relief packages. The Trump Administration has even revealed plans to lower pay for agricultural guest workers who sacrifice home and family to come to the United States to perform arduous farm labor. Advocates fear that decreasing guest worker wages would drive down wages for farmworkers already living and working in the United States.

Farmworkers are poor, with extremely limited access to healthcare and, due to their poverty, often work through illness. The risks of an outbreak is especially great because workers often toil in close physical proximity to one another as they harvest, ride to the fields in crowded buses and cars, have limited access to sanitary facilities, including hand-washing, and often live in overcrowded, dilapidated housing.

The majority of farmworkers are immigrants from Mexico or are the children of Mexican immigrants. The community is socially isolated from mainstream America. Poverty forced many farmworkers to leave school at an early age. It also causes them to bring their children to work in the fields so that child labor can supplement their meager incomes. Language and cultural barriers further their isolation. NCL, through the Child Labor Coalition (CLC), which it founded and co-chairs, has committed to the fight to fix the broken child labor laws that allow children in agriculture to work at early ages—often 12—and to begin performing hazardous work at age 16.

When the virus began to move into America’s rural areas, many socially- and culturally-isolated farmworkers hadn’t heard about the virus.  Some were confused that the grocery store shelves were empty and that the bottled water they usually buy suddenly cost much more.

In some cases, farmworkers reported that the farmers they work for have not told them about the virus or the need to take special precautions while working. Farmworkers face an alarming dearth of protective equipment. Many farmworkers groups, including UFW and Justice for Migrant Women, are urgently racing to provide masks and other protective gear.

A farmworker with COVID-19 is unlikely to know he or she has it and, therefore, very likely to keep working and infect their family and coworkers. Recently, a growers group tested 71 tree fruit workers in Wenatchee, Washington, according to a report in the Capital Press newspaper. Although none of the workers were showing symptoms of COVID-19, 36 workers—more than half—tested positive!

The conditions faced by farmworkers are a “superconductor for the virus,” noted advocate Greg Asbed of the Coalition of Immokalee Workers in a New York Times opinion piece, in which he concluded that “the U.S. food supply is in danger.”

The current circumstances reminded Asbed of a previous crisis: “A century ago in ‘The Jungle,’ Upton Sinclair wrote about how the teeming tenements and meatpacking houses where workers lived and labored were perfect breeding grounds for tuberculosis as it swept the country. Now there is a new pathogenic threat and the workers who feed us are once again in grave danger,” said Asbed, adding that the “ two most promising measures for protecting ourselves from the virus and preventing its spread—social distancing and self-isolation—are effectively impossible in farmworker communities” because farmworkers live and work so closely together.

The looming food crisis is not just an American phenomenon, reported the New York Times. “The world has never faced a hunger emergency like this, experts say. It could double the number of people facing acute hunger to 265 million by the end of this year,” noted reporter Abdi Latif Dahir. “The coronavirus pandemic has brought hunger to millions of people around the world. National lockdowns and social distancing measures are drying up work and incomes, and are likely to disrupt agricultural production and supply routes—leaving millions to worry how they will get enough to eat,” added Dahir.

An article in The Washington Post warned that, in the United States, the farm–to-grocery distribution system is breaking down under the strain of the virus and that farmers are plowing in fields of crops. The Trump administration has announced a $19 billion plan to buy agricultural products and get them to food banks, which are experiencing shortages and, in some cases, mile-long lines of cars waiting for help.

In the United States, the federal government’s responses have been focused on helping farmers—which is fine; we all want farmers to be helped—but we cannot forget or neglect the needs of desperately poor farmworkers. In the absence of federal aid, some states are working to protect vulnerable farmworker populations. To help achieve social-distancing, Washington State has set housing rules requiring guest workers have double the current space.

Wisconsin issued similar rules requiring six-foot social distancing for farmworkers as they work in the fields, ride on buses, and sleep in grower-provided housing. The plan mandates protections for farmworkers who acquire the virus and calls for fines of up to $500 for violations.

In an April 15 letter, Pennsylvania’s Governor Tom Wolf urged the U.S. Department of Agriculture to “take swift and decisive action to publicize and implement a plan to immediately and equitably stabilize the agriculture industry, and to support agriculture producers, food processors, workers, and local food systems, regardless of the size of the operation. This plan must include resources, guidance, and protection for these workers,” Wolf continued. “Every sector of agriculture, food processing and distribution, retail, grocery stores, and farmers markets are negatively impacted by COVID-19 and need support.”

“The closing of many child care facilities has meant many farmworker women must stay home with children, which translates to lost income and fewer workers for farmers,” noted Cleo Rodriguez, a CLC-member who heads the National Migrant and Seasonal Head Start Association.

“The closing of schools may mean that younger teens are increasingly pulled into agricultural child labor,” suggested Norma Flores López, who heads the CLC’s efforts to protect farmworker children. “We’re very concerned with the number of children that are going to be working in the fields,” said Flores López, adding that child labor increases children’s risk of exploitation, wage theft, and sexual exploitation.

Concerned about these developments, the CLC wrote letters this week to several appropriators and the Committee on Agriculture, asking for additional nutritional and childcare resources for farmworker families.

We all need to eat. It’s incumbent upon us to protect farmworkers and our food supply chain. “It’s time to step up,” said Rodriguez.

Here’s what consumers can do to help protect farmworkers in these dire circumstances:

  • Sign the Food Chain Workers Alliance to urge Congress to include resources for food chain workers: https://tinyurl.com/yddvcm2w.
  • Sign UFW’s petition urging Congress to stop Trump administration efforts to lower wages for agricultural guest workers: https://tinyurl.com/y9jgtsow.
  • Make masks and send them to farmworker groups in your state.
  • Urge congressional representatives to fund farmworker relief efforts.
  • Donate to any of the excellent farmworker groups we’ve mentioned in this piece.

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

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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.

 

A few out-of-the-box consumer tips for staying safe from coronavirus

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By Sally Greenberg, NCL Executive Director

At the National Consumers League, we’re all about protecting consumers during this terrible coronavirus pandemic. Most of us understand that we need to social distance, work from home if possible, wear masks when going out—especially on trips to the grocery or drug store—and not gather in groups larger than 10.

Yesterday, I had a conversation with my doctor to hear what she is telling patients about testing kit availability for both the virus and antibodies test, and to hear what other advice she is giving. She told me some things I’d like to pass along:

  • The Food and Drug Administration (FDA) relaxed requirements for developing COVID-19 tests and as a result, there are many kits to test for antibodies available for sale but very few—4 to date—have been approved by the FDA as high-quality and accurate. Consumers, don’t waste your money on phony or inaccurate tests.
  • Neither she nor any doctor she knows has access to the high-quality antibody tests. The good news is that there is plenty of capacity for testing people with COVID-19 symptoms. That was not always the case, so it’s a hopeful sign that there will be high-quality antibody tests available when the industry really ramps up.
  • For those who’ve had COVID-19 and recovered, the presence of antibodies alone is not sufficient. The best tests will show the level of antibody protection and whether those levels meet the threshold to protect us from contracting the disease.
  • Contact tracing is critical to curb this illness. My doc has traveled throughout the world and lived abroad for periods of time. She says without contact tracing we cannot hope to contain the disease. Former Peace Corp workers and health care providers who have worked around the world have this down to a science. Anyone who has been exposed to someone with COVID-19 has to go into quarantine for 14 days. My doc says that USAID has been doing this for many years when there’s an outbreak and it’s critical to containing the disease.

Until the appropriate infrastructure to test and contact trace for COVID-19 is established, my doctor suggested the following:

  • She recommends taking extra Vitamin C, extra Vitamin D, and Zinc. As a result, I’m taking two multivitamins each day based on the level of those three she is recommending.
  • She recommends getting some sun for at least 30 minutes a day to boost your immune system. Hopefully, most consumers are in climates that provide access to sunshine and can get outside. We know that is hard for people in apartment buildings or who have disabilities or live alone and don’t have support.
  • Finally, don’t assume you’ve been exposed and have antibodies just because you haven’t gotten sick. Until we have a vaccine, along with robust testing and contact tracing in place, we must continue to social distance.

 

Coronavirus and unsafe working conditions for poultry workers

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By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

In these uncertain times of COVID-19, many workers are being exposed to the disease at poultry plants across the United States. Eater notes that many of these workers are Black, Latino, or immigrants earning low wages and working in overcrowded conditions to package the items that end up on the plates of many families across the States.

Let us dive in a little deeper. The Los Angeles Times has highlighted the spike in coronavirus and meat plants across the United States, with hundreds of reported cases in the last week. This is, of course, a concern to the food supply chain and worker safety. The Associated Press has reported that massive meat processing plants have temporarily closed due to workers contracting COVID-19. This raises concerns about shortages of beef, pork, and poultry. At the same time, workers are being exposed and are succumbing to COVID-19.

The New York Times also reported that workers are standing elbow-to-elbow to do the low-wage work of cutting and packing meat. Many have been on the front line of these packing plants while being sick because they cannot afford to stay home and sacrifice paychecks. Some have staged walkouts to protest being insufficiently protected. United Food and Commercial Workers (UFCW), which has a seat on the National Consumers League’s Board of Directors, has engaged in talks with Cargill, which has agreed to give employees a $2/hour emergency pay increase in addition to a pay raise. The union and Cargill are working on ways to better practice social distancing within the packing plants. Increased sanitization and screening at the plants, and virtual health visits will be expanded for those seeking care health care.

Each day brings new information about COVID-19. When going to the store to purchase meat, let us remember that someone stood in a plant slaughtering and packing it. They are on the frontline risking their lives so that we can eat. UFCW is calling on ALL food employers to step up by developing ways to protect workers and by compensating them commensurate with the risks they are taking to deliver quality products to the grocery stores, restaurants, and family tables of America.

Multi-agency initiative invites public and private partners to collaborate on strategy to reduce food waste

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Shaunice Wall is NCL’s Linda Golodner Food Safety and Nutrition Fellow
An estimated 40 percent of food goes uneaten in the United States. Between 2007 and 2014, American consumers wasted nearly 150,000 tons of food per day. Yet, 40 million Americans struggle with hunger, including 12 million children.

Read more

Universal testing: What is the hold-up?

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By Sally Greenberg, NCL Executive Director

During this Covid pandemic, Americans have been incredibly patient and observant of guidelines for social distancing and staying home. But it can’t last forever. Where the heck is the universal testing for Covid-19? We’ve been talking about it for more than two months and yet you can’t get access to Covid-19 testing unless you’re showing symptoms of the virus. If, as experts believe, 25-50 percent of us might be carrying the virus without symptoms, what does that say?

It says we could be spreading the virus without knowing it! And yet we can’t get tested? We need greater accessibility to testing to know where we stand. If everyone could be tested each day to know if we do or don’t have the disease, or be tested for antibodies to Covid-19 to learn that we can fight the disease, we’d be better equipped to know what we’re dealing with and make smart decisions. Such universal testing can get the country back to work, especially at a time when the economy is in even worst shape since the Great Depression with the retail, restaurant, airline, entertainment, film and hotel industries ground to a halt and millions of workers across the economy out of jobs.

And take note: this kind of testing is possible because testing does not need to require a site visit. A study funded by UnitedHealth Group shows people can self-administer a diagnostic test with a much smaller swab, a process that should save potentially thousands of clinicians from being exposed to the virus while at the same time making the testing simpler. The study, which used data from 500 OptumCare patients, comes amid a parade of diagnostic test approvals for Coronavirus following weeks of criticism of the Trump administration and federal agencies for the lack of testing.

On March 24, the “White House Coronavirus Task Force reported in a briefing that “self-swabbing” options were going to be available that week, so the study supports what the federal government is pursuing.” That’s almost a month ago – so where are they?

What’s worse is that the United States is considered well behind other countries when it comes to the availability of testing generally. Why can’t we figure out this solution?

NCL friend and brilliant inventor of the SawStop, a safe table saw, Steve Gass, came up with a novel approach to employ universal testing that would get most of us back to work. His proposal is below. I’ll end with it, because it says it all:

A cure for the coronavirus pandemic already exists. Contrary to our expectation that cures manifest exclusively as biological agents – medicine for the sick or vaccines for the healthy – the cure for this outbreak is technological. From the Oval Office to Kansas kitchens we’re already talking about it, even while failing to recognize its true potential. Those elusive Covid-19 tests, if utilized daily, by every American, have the power to save our lives and our economy within the month.

To date, the U.S. has only employed testing reactively — to diagnosis a disease after symptoms indicate probable infection — which wins us no real advantage when epidemiological evidence indicates up to 40 percent of transmissions occur covertly, days before symptoms appear, and CDC director Dr. Robert Redfield estimates that 25 percent of carriers (and spreaders) may never manifest symptoms at all. We can continue to hide out at home indefinitely, banking on a vaccine in 12-18 months, but public health expert Dr. David Katz calls that a recipe for “ineffectively fighting the contagion even as we are causing economic collapse.”

Instead, we must deploy tests offensively. They must become our mass-produced instruments of war.

Here’s the plan of attack: one month from today, each of us is tested daily for Covid-19, obtaining immediate results. If positive, you isolate at home and instantaneously eliminate the virus’s prime advantage: its ability to stealthily propagate from “people out there shedding the virus who don’t know that they’re infected,” according to infectious diseases expert Dr. Jeffery Shaman. Meanwhile, the healthy among us freely move back out into our communities, flashing our daily health certificates like boarding passes to gain admittance to workplaces, schools, and stores, certain we won’t harm or be harmed by the people with whom we interact. We’ll have immediately shifted, as economists Dr. Paul Romer and Dr. Alan M. Garber insist we must, to a “targeted approach that limits the spread of the virus but still lets most people go back to work.” The very first day we implement universal daily testing and selective isolation commerce resumes, the viral transmission rate plummets, and the virus exponentially decays. The crisis ends.

The challenge in this crisis of scarcity, when too few can access masks let alone diagnostic devices, is to build enough testing units, now, so that all 330 million Americans can be tested daily. This will require at least 1 million community-based machines adapted for parallel processing of multiple tests simultaneously. If we begin tomorrow and labor 24 hours per day it will take just under 12 days to produce and deploy a million machines at a production rate of one unit every second. That’s not just daunting. It’s mind-boggling.

But it’s not impossible.

In May of 1940 the Greatest Generation listened incredulously as President Roosevelt challenged them to “harness the efficient machinery of America’s manufacturers” to produce 50,000 combat aircraft in 12 months to confront the “approaching storm” of a global war – a goal exceeding the total of all planes built in the U.S. since the Wright brothers’ initial 1903 flight. No one believed an 18-ton plane with 450,000 parts and 360,000 rivets in 550 different sizes could be mass produced, let alone efficiently. But our repurposed auto factories did just that, with Ford Motor Co. churning out one bomber per hour at peak production to secure our safety and win the war.

Our nation still has the know-how, the manufacturing infrastructure, and the industrial resources to save ourselves again by building and deploying a million Covid-19 testing units by the end of the month if we make it our highest national priority starting today. We have men and women yearning to go back to work and we must employ them to optimize established supply chains, man assembly lines, and reinvigorate distribution channels. No single state’s factories can meet the one-unit-per-second output required, but pooled national resources can. The cost and effort will be substantial, certainly, but pale in comparison to the misery wreaked if we let a quarter million Americans die instead.

Make no mistake: World War III is upon us. We must once again wake the sleeping giant, mustering America’s industrial might to save ourselves and the whole world with us by rallying resources to test each of us, over and over again, as if our livelihoods and lives depend on it.

Because they do.

—–

Stephen Gass, PhD, J.D., is a physicist, a patent attorney, and the retired President and founder of SawStop, LLC, the nation’s foremost supplier of premium table saws and the world leader in table saw safety. He is the principal inventor on over 100 patents covering electrical and mechanical innovations in power tools.

Safe takeout options under coronavirus

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By Nailah John, Linda Golodner Food Safety and Nutrition Fellow

The way we get food now has totally changed due to the Covid-19 virus. Most us around the nation no longer go to our favorite bar or restaurant or stop at the local coffee shop for a bite to eat or to socialize and have a drink. The mandatory closure shutdown of restaurants with the exception of takeout or delivery is our only option of enjoying a meal not cooked at home. Beyond that, we may ask the questions: first is it safe? Second: is it ethical to potentially expose a delivery worker to what we are all trying to avoid the risk of Covid-19?

The answer to the first question is yes, with some caveats. Currently food is not associated with the transmission of Covid-19, according to the CDC and the Food and Drug Administration. However, Vox reports that there is growing evidence of fecal/oral transmission, which means you can ingest the virus shed in feces through inadequate handwashing or contaminated food and water. Therefore, handlers of food who carry the virus can spread the virus to food items. In theory, all restaurants have to follow food safety rules, and there are extra measures that have been put in place due to Covid-19. However, we have seen Chipotle and other restaurants spread infections by poor food handling.

The second question is complicated, but here are some thoughts. Currently delivery workers are in the middle of a pandemic but still have to work to support their families and pay bills. Eater suggests that if customers forego take-out food, delivery workers and restaurants struggling to provide during the crisis could be put out of business.

We recommend ordering take-away food from your favorite restaurants and, even better, support them by buying gift cards for post-pandemic future meals when restaurants re-open.

Your first option is to is use the in-house restaurant delivery option, since third-party apps take commission fees, which reduce the profit for restaurants. Here are some apps that are taking the necessary measures in protecting their workers and helping out the restaurant industry.

  • UberEats is working to provide drivers with disinfectant. With limited supplies they are working with suppliers to source as much as possible. Any delivery worker who is diagnosed with Covid-19 or is individually asked to self-isolate by a public health authority will receive financial assistance for up to 14 days. UberEats customers have the option to choose how they would like their orders delivered, including selecting “leave at door” during checkout. UberEats has also waived the delivery fee for more than 100,000 independent restaurants across the USA and Canada.
  • Postmates launched the Postmates Fleet Relief Fund to help fleet workers cover medical expenses related to Covid-19, regardless of diagnosis. Active members of the fleet who receive a positive diagnosis for Covid-19 or who are required to self-quarantine based on infection may be eligible to access additional funds to offset up to two weeks of lost income while they recover. Postmates has also introduced non-contact deliveries, which allows distancing between customers and delivery workers. Postmates will also waive commission fees for businesses in the San Francisco Bay area.
  • DoorDash (also owns Caviar) is providing financial assistance to eligible delivery workers and Caviar couriers who are diagnosed with Covid-19 or quarantined. DoorDash is consulting with public health officials and working with restaurants to enhance their food preparation protocols. The default delivery method has been changed to the non-contact option to minimize contact between the delivery workers and customers. All new and existing DoorDash partner restaurants will receive commission relief and marketing support.
  • Grubhub is offering a one-time pay adjustment to help with medical expenses and loss of income if a driver tests positive with Covid-19. Grubhub will also support drivers who have been ordered by a public health authority or licensed medical personnel to self-isolate due to a risk of spreading Covid-19, and if a driver’s account has been individually restricted as a result of information provided to Grubhub by a public health authority regarding the risk of spreading Covid-19. Grubhub has also introduced contact-free delivery, which allows customers to request having their delivery left at the front door to avoid less contact.
  • On March 9, Instacart introduced a new sick pay policy that all part-time employees including in-store shoppers now have access to sick pay, an accrued benefit that can be used as paid time off for absences from work due to illness or injury. This pay accrual will be backdated from the start of the year for all in-store shoppers. Instacart is also offering 14 days of pay for any part-time employee and full-service shoppers who are diagnosed with Covid-19 or are under mandatory isolation or quarantine directed by local, state, or public health authority. This assist will be available for 30 days. Instacart has also introduced “Leave at my Door Delivery” to all customers across North America.

It is important that we minimize contact with others since daily things are changing in relation to Covid-19. However, delivery services are really stepping up to keep customers safe and, for that, we should all be grateful. Remember to support your local restaurants by requesting non-contact delivery!

 

Kudos to merchants fighting price gouging

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By Sally Greenberg, NCL Executive Director

There I was, searching for hand sanitizer to help keep reducing my risk of infection. I had scoured my local stores for hand sanitizer, to no avail. At last, desperate, I found a tiny bottle of sanitizer on the shelf at my local gas station. A bottle that usually retails for around a dollar was marked up to $3.99. What choice did I have? I paid the money and walked out of the store.

Like moths to the flame, profiteers cannot resist the allure of easy money. In this time of national emergency, it should perhaps come as little surprise that those who wish to make a quick buck off the desperation of consumers are finding few obstacles in their way.

In past natural and man-made disasters, whether in the aftermath of Hurricane Katrina or the 2008-09 financial crisis, there were always crooks who sought to deprive those in need of their last penny. Unfortunately, the COVID-19 crisis seems to be little different in this respect.

Price gouging is perhaps the most immediate threat. Most of us are aware of being asked to pay $5.00 for a bottled water in an airport or amusement park. In a time of crisis, however, the consequences of hiking prices outrageously is more than just a matter of a parched throat. For consumers in desperate need, it can come down to a choice between avoiding infection or paying the rent.

At a time when health care workers and first responders are putting their lives on the line to care for coronavirus patients, it is outrageous to see stories of unscrupulous sellers marking up the price on masks, hand sanitizer, disinfectant and, yes, even toilet paper.

Price gouging in times of crisis is illegal in most states. For example, Maryland’s anti-gouging statute prohibits raising the price of many consumer goods and services that increase the seller’s profit by more than 10 percent while the COVID-19 emergency declared by Governor Larry Hogan is in effect. California has a similar statute, punishable by up to a year in jail and a $10,000 fine. Price gouging is also illegal where I live, in the District of Columbia.

While state laws are important, enforcement alone won’t solve this problem. Reputable businesses must also play their part to keep price gouging off their shelves. This is one reason I was especially encouraged to see that that the biggest seller of consumer items on the planet, Amazon.com, stepped out so decisively against price gouging.

Last month, the company issued a policy that clearly states: “Amazon has zero tolerance for price gouging and longstanding policies to prevent this harmful practice.” In practice, this means the company is working overtime to remove price gougers from its marketplace, forwarding reports of price gouging to law enforcement, and making it clear to their sellers that price gouging is not allowed.

Amazon has removed more than half a million products and suspended more than 3,900 seller accounts in the United States.

The overwhelming majority of sellers on sites like Amazon, eBay, and other online marketplaces are honest. But these e-commerce marketplaces are where millions of consumers are going to find much-needed products. Particularly for consumers who are at high risk, these online services can be a lifeline, enabling them to stay home, avoid going out into public, and decreasing their chances of contracting the virus.

We should be very happy that there are state laws prohibiting price gouging and very grateful that Amazon has taken such a strong stance in protecting consumers by monitoring and prohibiting its sellers from gouging consumers and others during this terrible pandemic.

Ten years later: ACA consistently proves to be America’s safety net, especially in times of crisis

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

Ten years ago, the United States Congress adopted the Affordable Care Act (ACA), after many decades of unsuccessful attempts at achieving universal health care by advocates. For the first time, the ACA provided coverage options for every American across the economic spectrum, expanding Medicaid in many states and offering the self-employed access to insurance on the open exchange. For NCL, the ACA is the safety net program the founders of the League sought to see put in place from the organization’s inception at the turn of the 20th Century.

Today with the rapid spread of the COVID-19 virus across America, patients’ access to health care is more critical than ever. Yet despite the clear need we all have for health care coverage, over the past decade, the ACA has been under attack by conservatives in Congress and survived multiple attempts at repeal. The latest came from the Texas v. United States case – and now it threatens to render the entire ACA unconstitutional, following the repeal of the ACA’s  individual mandate provision. Why conservatives wish to deprive people of health care escapes us at the NCL. In fact, the ACA has transformed the way Americans interact with the healthcare system.

Throughout its short life, the ACA has cemented into law numerous consumer health protections and has expanded access to health coverage for over 20 million people. 37 states have expanded Medicaid, the health care program for low-income Americans. Prioritizing preventive care, the ACA mandated that health insurance providers  cover preventive services for all adults, women, and children – free of cost to the patient. The ACA also made it unlawful for insurers to deny or reduce benefits based on preexisting conditions. These include diagnostic included screenings, vaccines, birth control, and access to certain medications. For the first time, those 26 under could retain their health coverage through their parents’ insurance plans.

Research has shown that ACA Medicaid Expansion has improved access to care, financial security, health outcomes, economic mobility, and have reduced uncompensated care. Despite the progress made by the ACA, there are still 29 million uninsured people in the United States. If the ACA is repealed, 25 million Americans may lose their coverage overnight, without the promise of its replacement. Perhaps the COVID-19 outbreak will change the calculus and bring home how devasting it would be to repeal the ACA. Insurers would no longer be obligated to provide protections offered by the law, allowing plans to deny coverage indiscriminately, leaving millions of families along with low-income and high-risk individuals without care.

The true impact of the ACA will be even more apparent as the national continues to grapple with the COVID-19 pandemic in the coming months. COVID-19 has upended the economy and affected virtually every industry and has caused unemployment to soar. On March 21, unemployment claims reached a record 3.3 million – the highest level of jobless claims in history (the Great Depression saw levels of 24 percent unemployment at its peak but there was no unemployment insurance safety net during the 1930s and thus no jobless claims, just breadlines). Economist Heidi Shierholz of the Economic Policy Institute estimates that by summer, approximately “14 million workers will lose their jobs due to the coronavirus shock.”

A report by FAIR Health estimates that potential treatment for COVID-19, resulting in an average six-day hospital stay, could total to a whopping $73,300 for the uninsured: a devastating prospect in the middle of a global financial collapse. With the increased loss of employer-based health insurance, the ACA proves to be more crucial than ever as individuals and families may turn to the health insurance marketplace to secure coverage. NCL is backing legislation – and the health plans support this too – to move workers losing jobs and health insurance to the COBRA program with heavy subsidies so they can ride out the pandemic –  COVID-19 has exposed so many severe deficiencies in the healthcare system. To learn more about statewide efforts to mitigate the impact of COVID-19, click here.

While the fate of the ACA remains uncertain, it is still the law of the land. If you are concerned about loss of coverage during this time, several state-run health plans have enacted Special Enrollment Periods (SEPs) in response to the COVID-19 outbreak, click here to learn more. NCL believes that healthcare is a right and that protections offered by the ACA make this country a far stronger, more robust nation. We will continue to work diligently to protect universal access affordable and reliable health coverage. To learn more about what’s at stake and how you can help prevent the potential repeal of the ACA, click here.