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檢測新冠病毒需要花多少錢?美國人仍有很多疑問

Daria Solovieva
2020-03-21

即便是有保險的人士進行檢測,也還有很多細節(jié)問題要厘清。

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隨著聯(lián)邦政府近期措施的出臺,以及許多私人倡議的實施,COVID-19病毒測試數(shù)量開始提升,但有關誰能夠獲得測試,誰為病毒測試以及可能需要的后期治療買單,這些措施多大程度上可以阻遏COVID-19在美國各地的傳播,依然是問題多于答案。

周日在白宮的記者招待會上,副總統(tǒng)邁克·彭斯再次強調,這些措施將會幫助到所有的美國人,但他沒有提供具體細節(jié)。上周他曾宣布“所有的保險公司”同意“豁免所有新冠病毒測試的定額手續(xù)費部分,并將保險的所有福利計劃都覆蓋到新冠病毒的治療?!?/p>

“隨著測試的推廣,我們很高興地看到,國會與政府攜手來確保成本問題永遠不會成為任何人獲得病毒測試的障礙,”彭斯在情況介紹會中說?!澳壳八械男鹿诓《緶y試都是免費的,每個美國人都能免費獲得測試,包括沒有保險的美國人。”

保險商承擔病毒感染爆發(fā)所帶來壓力的投入程度,以及聯(lián)邦政府和各州對抗疫的支持程度,還有待觀察。

據(jù)白宮稱,藍十字藍盾、安泰、信諾、休曼納和聯(lián)合健康公司將參與其中。目前為止,大多數(shù)保險公司承諾豁免COVID-19病毒測試的定額手續(xù)費部分,但對治療的定額手續(xù)費部分尚未豁免?!敦敻弧冯s志聯(lián)系了白宮提到的所有保險公司,大多數(shù)只提供了在線聲明或者郵件評論。信諾沒有予以回復。

比如,藍十字藍盾的COVID-19病毒防疫指引稱,保險覆蓋范圍“將與被保險成員健康利益的標準條款相一致” 。

有些公司還覆蓋了遠程醫(yī)療的定額手續(xù)費部分?!叭绻虡I(yè)被保險人在實際就醫(yī)前接受了遠程醫(yī)療服務, 依照我們提供的未來90天內零定額手續(xù)費遠程醫(yī)療服務保險覆蓋,他們不需要支付定額手續(xù)費部分,”上述文字源自安泰的郵件聲明。

即便是有保險的人士,也還有很多細節(jié)問題要厘清。

“新冠病毒才不管你是有保險的,還是沒保險的,是民主黨人還是共和黨人,也不論你是黑人還是白人,”生物科技高管丹娜·格雷森說。她是自1月中旬以來就呼吁采取更嚴格防控措施的群體中的一員?!斑@不是一種只會攻擊富人或有保險人士的病癥。我們看到了受感染的人數(shù)在加速上升,而我們幾乎很少測試?!?/p>

對于大多數(shù)通過雇主公司獲取保險計劃的美國人來說,其境遇很大程度上要看聯(lián)邦政府即將決策實施的新法案和要求。眾議院周六通過了《家庭第一新冠病毒應對法案》,包括一些測試條款和為工人提供財務支持的條款。參議院將在本周審議。

這一法案包括建立“無成本為消費者提供新冠病毒診斷測試的要求,擴大失業(yè)人員的利益保障,以及暫時性地提高醫(yī)療補助力度。”盡管多數(shù)被感染者的癥狀較輕,但還是有一定比例的受感染者需要住院治療、呼吸器及其他支出。

“有保險但自費部分較高的人,自費部分恐怕會成為一種障礙,因為他們可能需要支出數(shù)百甚至數(shù)千美元,”喬治敦大學公共政策麥考特學院的醫(yī)療保險改革中心聯(lián)合主任薩布里娜·克萊特說。“眾議院的法案會幫助到這些人,手段是要求保險商和雇主豁免費用共攤,不光是測試,還有急診和門診?!?/p>

對大約三千萬沒有保險的美國人來說,財務上的不確定性可能更大。

最直接的影響和阻遏因素是許多人無法獲得測試。白宮成功安排測試的報道,與許多病人的體驗是脫節(jié)的,這些有潛在病兆的人因不符特定條件而被醫(yī)療機構拒絕測試,但他們可能攜帶病毒,并可能給其他人帶來風險。

圣芭芭拉菲爾丁研究生院的博士生妮可·巴德里納斯,就被加州弗里蒙特的帕拉奧圖醫(yī)療基金會拒絕病毒測試,盡管她當時已顯示出一些癥狀。

“他們說不會對我進行測試,因為我不屬于高風險,”巴德里納斯說,“我被告知,我不符合某些測試條件,比如呼吸困難?!?/p>

即使她跟八十多歲的父母一起居住,她還是被拒絕測試。

“他們告訴我,在家里時戴上口罩,并遠離父母,”她說,帶著一種挫敗感,她已放棄了去測試的想法?!昂呛?,真是太好了,我已經(jīng)跟他們在家一個禮拜了。”

在醫(yī)院門診處,醫(yī)生告訴她,如果開始有呼吸困難問題,就回來就醫(yī)。

很明顯,白宮夸大了上周病毒測試的安排速度和范圍。特朗普競選團隊全國發(fā)言人凱雷·邁克伊納尼在3月12日的推文中說,“已經(jīng)分發(fā)了一百萬個測試設備,本周末將會分發(fā)四百萬個,”美國總統(tǒng)也發(fā)推文重申了這一點。

根據(jù)疾控中心3月17日發(fā)布的數(shù)據(jù),疾控中心實驗室總計已進行了4255份測試,公共衛(wèi)生實驗室測試了27623份。

在遭受COVID-19病毒沖擊的國家中,如果按每百萬人的測試比例排名,美國排在倒數(shù)位置。美國測試的人數(shù)不到法國的一半,而法國人口比美國少得多。

據(jù)《商業(yè)內幕》報道,盡管測試能力有限,但一些高凈值病人可以在家獲得病毒測試,這是由比如大衛(wèi)·納扎里安等特約醫(yī)生提供的“家政電話”服務的一部分。一些名人比如海蒂·克魯姆可以獲得在家測試還分享到社交媒體,引發(fā)了強烈反應,人們感慨“有錢有名望的”就可以獲得這種服務。

彭斯在周日的記者招待會上重申,所有的新冠病毒測試將是免費的,但很多責任會落到各個州以及私人公司身上去落實。

有些州,比如馬薩諸塞、賓夕法尼亞和加利福尼亞州,已經(jīng)強制要求豁免COVID-19測試和治療的定額費用部分。

周一倫敦帝國理工學院發(fā)表的一篇報道指,研究者估計COVID-19將感染美國人口的81%,死亡人數(shù)光是在美國就將高達220萬,如果沒有及時采取措施緩解疫情的話。全美各地的護理機構和接線中心的電話都被打爆了。

“我們當然很擔心,”注冊護士杰森·菲利普說,他在過去幾天見證了日常接電話數(shù)量的成倍上升。許多人打電話來詢問基本信息,以及在何地以何種方式可以獲得測試。

“我感覺在加州南部,有很多人應該馬上接受測試,以幫助公共衛(wèi)生系統(tǒng)的防疫努力,但我們實在太忙了,”菲利普說,“我們能做的就是與病人電話預約好,并叫他們在獲得醫(yī)療指示之前自行隔離。”

他也很擔心基本的防護用品和口罩的短缺。

“由于這第一波的社區(qū)感染期間的疾病傳播和隔離措施,我們將失去很多醫(yī)療工作人員,”菲利普說。

標普指數(shù)內的保險公司上周有一份分析報告稱,誰來承擔COVID-19病毒爆發(fā)的大部分成本,或許也要看當前措施的有效程度。

“大多數(shù)有保險的人士,尤其是機構或雇主保險計劃內的人,在今年后半期之前,不會達到他們自費部分的上限,”標普分析師在3月12日發(fā)表的一份報告中寫道,“所以,如果能在今年上半年遏制COVID-19的傳播,有保險的人士會承擔治療成本的大部分。不過,如果到下半年病毒還持續(xù)傳播,而有保險人士已達到成本共攤的要求,保險公司將直接承擔醫(yī)療費用的更大部分?!?/p>

有些社區(qū)和一些其他國家,已經(jīng)行動起來解決潛在的經(jīng)濟困難問題,甚至由于疾病爆發(fā)導致的破產(chǎn)問題,但對于沒有醫(yī)療保險的工人們的醫(yī)療保障條款細節(jié),還是很有限。

已有一些衛(wèi)生領域的專家敦促聯(lián)邦政府擴大聯(lián)邦條款覆蓋范圍,降低醫(yī)療補助門檻,采取諸如“創(chuàng)建一頁式申請書,讓人們持續(xù)獲得補助,而不需要不斷地進行機構認可”或者允許“各個州臨時性地增加醫(yī)療補助可獲得性,擴大資格要求的收入范圍,突破現(xiàn)有的收入限制?!?/p>

最不可能被測試的很多人,比如身體最虛弱的人士和接觸人多的行業(yè)人士比如食品服務人員,直到那時才會獲得病毒測試。

“如果你沒有保險——要么是買不起保險,要么是你沒有工作——如果你去做病毒測試,你恐怕要費很大勁才能獲得免費測試,因為測試能力是如此之低,”格雷森說。“要么你測試完了,面對一張數(shù)千美元的收費單傻了眼,如果測試結果是陽性你就不能返工。那為什么要去測試呢?不會去的,沒有動力?!保ㄘ敻恢形木W(wǎng))

譯者:宣峰

隨著聯(lián)邦政府近期措施的出臺,以及許多私人倡議的實施,COVID-19病毒測試數(shù)量開始提升,但有關誰能夠獲得測試,誰為病毒測試以及可能需要的后期治療買單,這些措施多大程度上可以阻遏COVID-19在美國各地的傳播,依然是問題多于答案。

周日在白宮的記者招待會上,副總統(tǒng)邁克·彭斯再次強調,這些措施將會幫助到所有的美國人,但他沒有提供具體細節(jié)。上周他曾宣布“所有的保險公司”同意“豁免所有新冠病毒測試的定額手續(xù)費部分,并將保險的所有福利計劃都覆蓋到新冠病毒的治療。”

“隨著測試的推廣,我們很高興地看到,國會與政府攜手來確保成本問題永遠不會成為任何人獲得病毒測試的障礙,”彭斯在情況介紹會中說?!澳壳八械男鹿诓《緶y試都是免費的,每個美國人都能免費獲得測試,包括沒有保險的美國人?!?/p>

保險商承擔病毒感染爆發(fā)所帶來壓力的投入程度,以及聯(lián)邦政府和各州對抗疫的支持程度,還有待觀察。

據(jù)白宮稱,藍十字藍盾、安泰、信諾、休曼納和聯(lián)合健康公司將參與其中。目前為止,大多數(shù)保險公司承諾豁免COVID-19病毒測試的定額手續(xù)費部分,但對治療的定額手續(xù)費部分尚未豁免?!敦敻弧冯s志聯(lián)系了白宮提到的所有保險公司,大多數(shù)只提供了在線聲明或者郵件評論。信諾沒有予以回復。

比如,藍十字藍盾的COVID-19病毒防疫指引稱,保險覆蓋范圍“將與被保險成員健康利益的標準條款相一致” 。

有些公司還覆蓋了遠程醫(yī)療的定額手續(xù)費部分。“如果商業(yè)被保險人在實際就醫(yī)前接受了遠程醫(yī)療服務, 依照我們提供的未來90天內零定額手續(xù)費遠程醫(yī)療服務保險覆蓋,他們不需要支付定額手續(xù)費部分,”上述文字源自安泰的郵件聲明。

即便是有保險的人士,也還有很多細節(jié)問題要厘清。

“新冠病毒才不管你是有保險的,還是沒保險的,是民主黨人還是共和黨人,也不論你是黑人還是白人,”生物科技高管丹娜·格雷森說。她是自1月中旬以來就呼吁采取更嚴格防控措施的群體中的一員?!斑@不是一種只會攻擊富人或有保險人士的病癥。我們看到了受感染的人數(shù)在加速上升,而我們幾乎很少測試?!?/p>

對于大多數(shù)通過雇主公司獲取保險計劃的美國人來說,其境遇很大程度上要看聯(lián)邦政府即將決策實施的新法案和要求。眾議院周六通過了《家庭第一新冠病毒應對法案》,包括一些測試條款和為工人提供財務支持的條款。參議院將在本周審議。

這一法案包括建立“無成本為消費者提供新冠病毒診斷測試的要求,擴大失業(yè)人員的利益保障,以及暫時性地提高醫(yī)療補助力度?!北M管多數(shù)被感染者的癥狀較輕,但還是有一定比例的受感染者需要住院治療、呼吸器及其他支出。

“有保險但自費部分較高的人,自費部分恐怕會成為一種障礙,因為他們可能需要支出數(shù)百甚至數(shù)千美元,”喬治敦大學公共政策麥考特學院的醫(yī)療保險改革中心聯(lián)合主任薩布里娜·克萊特說?!氨娮h院的法案會幫助到這些人,手段是要求保險商和雇主豁免費用共攤,不光是測試,還有急診和門診?!?/p>

對大約三千萬沒有保險的美國人來說,財務上的不確定性可能更大。

最直接的影響和阻遏因素是許多人無法獲得測試。白宮成功安排測試的報道,與許多病人的體驗是脫節(jié)的,這些有潛在病兆的人因不符特定條件而被醫(yī)療機構拒絕測試,但他們可能攜帶病毒,并可能給其他人帶來風險。

圣芭芭拉菲爾丁研究生院的博士生妮可·巴德里納斯,就被加州弗里蒙特的帕拉奧圖醫(yī)療基金會拒絕病毒測試,盡管她當時已顯示出一些癥狀。

“他們說不會對我進行測試,因為我不屬于高風險,”巴德里納斯說,“我被告知,我不符合某些測試條件,比如呼吸困難?!?/p>

即使她跟八十多歲的父母一起居住,她還是被拒絕測試。

“他們告訴我,在家里時戴上口罩,并遠離父母,”她說,帶著一種挫敗感,她已放棄了去測試的想法?!昂呛?,真是太好了,我已經(jīng)跟他們在家一個禮拜了。”

在醫(yī)院門診處,醫(yī)生告訴她,如果開始有呼吸困難問題,就回來就醫(yī)。

很明顯,白宮夸大了上周病毒測試的安排速度和范圍。特朗普競選團隊全國發(fā)言人凱雷·邁克伊納尼在3月12日的推文中說,“已經(jīng)分發(fā)了一百萬個測試設備,本周末將會分發(fā)四百萬個,”美國總統(tǒng)也發(fā)推文重申了這一點。

根據(jù)疾控中心3月17日發(fā)布的數(shù)據(jù),疾控中心實驗室總計已進行了4255份測試,公共衛(wèi)生實驗室測試了27623份。

在遭受COVID-19病毒沖擊的國家中,如果按每百萬人的測試比例排名,美國排在倒數(shù)位置。美國測試的人數(shù)不到法國的一半,而法國人口比美國少得多。

據(jù)《商業(yè)內幕》報道,盡管測試能力有限,但一些高凈值病人可以在家獲得病毒測試,這是由比如大衛(wèi)·納扎里安等特約醫(yī)生提供的“家政電話”服務的一部分。一些名人比如海蒂·克魯姆可以獲得在家測試還分享到社交媒體,引發(fā)了強烈反應,人們感慨“有錢有名望的”就可以獲得這種服務。

彭斯在周日的記者招待會上重申,所有的新冠病毒測試將是免費的,但很多責任會落到各個州以及私人公司身上去落實。

有些州,比如馬薩諸塞、賓夕法尼亞和加利福尼亞州,已經(jīng)強制要求豁免COVID-19測試和治療的定額費用部分。

周一倫敦帝國理工學院發(fā)表的一篇報道指,研究者估計COVID-19將感染美國人口的81%,死亡人數(shù)光是在美國就將高達220萬,如果沒有及時采取措施緩解疫情的話。全美各地的護理機構和接線中心的電話都被打爆了。

“我們當然很擔心,”注冊護士杰森·菲利普說,他在過去幾天見證了日常接電話數(shù)量的成倍上升。許多人打電話來詢問基本信息,以及在何地以何種方式可以獲得測試。

“我感覺在加州南部,有很多人應該馬上接受測試,以幫助公共衛(wèi)生系統(tǒng)的防疫努力,但我們實在太忙了,”菲利普說,“我們能做的就是與病人電話預約好,并叫他們在獲得醫(yī)療指示之前自行隔離?!?/p>

他也很擔心基本的防護用品和口罩的短缺。

“由于這第一波的社區(qū)感染期間的疾病傳播和隔離措施,我們將失去很多醫(yī)療工作人員,”菲利普說。

標普指數(shù)內的保險公司上周有一份分析報告稱,誰來承擔COVID-19病毒爆發(fā)的大部分成本,或許也要看當前措施的有效程度。

“大多數(shù)有保險的人士,尤其是機構或雇主保險計劃內的人,在今年后半期之前,不會達到他們自費部分的上限,”標普分析師在3月12日發(fā)表的一份報告中寫道,“所以,如果能在今年上半年遏制COVID-19的傳播,有保險的人士會承擔治療成本的大部分。不過,如果到下半年病毒還持續(xù)傳播,而有保險人士已達到成本共攤的要求,保險公司將直接承擔醫(yī)療費用的更大部分?!?/p>

有些社區(qū)和一些其他國家,已經(jīng)行動起來解決潛在的經(jīng)濟困難問題,甚至由于疾病爆發(fā)導致的破產(chǎn)問題,但對于沒有醫(yī)療保險的工人們的醫(yī)療保障條款細節(jié),還是很有限。

已有一些衛(wèi)生領域的專家敦促聯(lián)邦政府擴大聯(lián)邦條款覆蓋范圍,降低醫(yī)療補助門檻,采取諸如“創(chuàng)建一頁式申請書,讓人們持續(xù)獲得補助,而不需要不斷地進行機構認可”或者允許“各個州臨時性地增加醫(yī)療補助可獲得性,擴大資格要求的收入范圍,突破現(xiàn)有的收入限制?!?/p>

最不可能被測試的很多人,比如身體最虛弱的人士和接觸人多的行業(yè)人士比如食品服務人員,直到那時才會獲得病毒測試。

“如果你沒有保險——要么是買不起保險,要么是你沒有工作——如果你去做病毒測試,你恐怕要費很大勁才能獲得免費測試,因為測試能力是如此之低,”格雷森說?!耙茨銣y試完了,面對一張數(shù)千美元的收費單傻了眼,如果測試結果是陽性你就不能返工。那為什么要去測試呢?不會去的,沒有動力?!保ㄘ敻恢形木W(wǎng))

譯者:宣峰

As COVID-19 testing is poised to ramp up following the federal government’s recent measures and the rollout of a range of private initiatives, there are still more questions than answers about who will be able to access these tests, who will pay for them or any potential treatment, and how successful these measures will be in deterring the spread of the coronavirus across all parts of American society.

Speaking at the White House press conference on Sunday, Vice President Mike Pence once again stressed that the measures will support all Americans, but offered few details. Last week, he announced that “all the insurance companies” agreed “to waive all copays on coronavirus testing and extend coverage for coronavirus treatment in all of their benefit plans.”

“As we expand testing, we’re so pleased that Congress joined with our administration to make sure that cost is never going to be a barrier to anyone getting a coronavirus test,” Pence said at the briefing. “Now all coronavirus testing is free, and it’s free for every American, including uninsured Americans.”

The full extent of the insurers’ commitment to shoulder the burden of the outbreak, and the level of support from the federal and state level, remains to be seen.

Blue Cross Blue Shield, Aetna, Cigna, Humana and UnitedHealth Group were among the attendees at the event, according to the White House. So far most insurance companies have committed to waiving co-pays for COVID-19 testing only, not for treatment. Fortune reached out to all insurers named by the White House, and most referred to an online statement or offered comments via e-mail. Cigna did not respond to a request for comment.

For example, Blue Cross Blue Shield’s COVID-19 guidance says coverage “will be consistent with the standard provisions of the member’s health benefits.”

Some are also covering telemedicine co-pays. “If a commercial member sees a telemedicine provider for their follow-up visit, there are no co-pays as part of our zero co-pay telemedicine offering available for the next 90 days,” according to an e-mailed statement from Aetna.

Even for those with insurance, there are still a lot of details to be worked out.

“Coronavirus doesn’t care if you’re insured, uninsured, Republican, Democrat, black, or white,” said Dena Grayson, a biotechnology executive who was among a group of voices calling for tougher measures since mid-January. “This is not a disease that only hits rich people or insured people. We can see that the number of cases is accelerating, and we’re barely testing.”

For the majority of Americans who have their insurance plans through their employer, a lot of it depends on the new bill and the requirements the federal government will decide to put in place. The House of Representatives passed the Families First Coronavirus Response Act on Saturday, which includes some provisions for testing and financial support for workers. The Senate will be reviewing it this week.

The bill includes establishing “requirements for providing coronavirus diagnostic testing at no cost to consumers, expanding unemployment benefits, and temporarily increasing Medicaid assistance.” While for many the symptoms may be mild, a portion of those infected may require hospitalization, ventilators, and other costs.

“[For] people with insurance but high deductibles, the concern is that those deductibles will be a barrier because they could face hundreds or even thousands of dollars,” said Sabrina Corlette, codirector of the Center on Health Insurance Reforms (CHIR) at Georgetown University’s McCourt School of Public Policy. “The House bill would address those folks by requiring insurers and employers to waive cost-sharing, not just for the tests but for the emergency room visit or an office visit as well.”

The financial uncertainties are potentially even bigger for about 30 million of Americans who are not insured.

The most immediate concern and deterrent for many is access to testing. There is a disconnect between reports of a successful testing rollout from the White House and the experiences of many patients with potential symptoms being turned away because they don’t meet specific criteria, yet may still be carriers and present a health risk to others.

Nicole Badrinath, a doctoral student at Fielding Graduate University in Santa Barbara, was denied a coronavirus test despite displaying symptoms at Palo Alto Medical Foundation in Fremont, Calif.

“They said they will not test me because I was not high-risk,” Badrinath said. “I was told I was not meeting the requirements like shortness of breath.”

She was denied the test even though she lives with her parents who are in their late eighties.

“I was told to wear the mask at home and to stay away from them,” she said, frustrated and giving up on the idea of getting a test. “That’s fantastic. I’ve been at home with them for the last week.”

At the doctor’s office, she was told to come back if she started having breathing issues.

It’s clear that the White House overstated the speed and scope of testing last week. Trump campaign national spokesperson Kayleigh McEnany said in a tweet on March 12 that “1 million tests have already been distributed, with 4 million distributed by the end of the week,” an assertion that was retweeted by the U.S. President.

According to data published by the CDC as of March 17, a total of 4,255 tests have been run by CDC labs and 27,623 by public health labs.

When comparing the rate of testing per million people, the United States is in the bottom pack of the countries impacted by COVID-19. The U.S. has administered less than half the volume of tests France has, a country with a much smaller population.

Despite limited testing capacity, some high-net-worth patients have been able to access in-home tests as a part of the “house calls” offered by concierge doctors such as David Nazarian, Business Insider reported. Celebrities like Heidi Klum also shared being able to access a test, invoking a reaction on social media about how the “rich and famous” have access to these provisions.

Pence reiterated in Sunday’s press conference that all coronavirus testing will be free, but a lot of the responsibility will likely fall on the states and private companies to enforce.

Several states like Massachusetts, Pennsylvania, and California are moving to mandate waiving co-pays both for COVID-19 testing and treatment.

In a report published by Imperial College London on Monday, researchers estimate COVID-19 could infect 81% of the U.S. population and as many as 2.2 million could die in the U.S. alone if severe, immediate measures are not taken to mitigate the epidemic. The volume of calls to nurses and call centers is surging across the country.

“We’re definitely concerned,” said registered nurse Jason Phillips, who has witnessed the tripling of his daily volume of calls over the past few days. A lot of people are calling in for basic information, he noted, as well as how and where to get tested.

“There were many people I feel should have been tested right away to help the public health effort in Southern California, but our hands were tied,” said Phillips. “The best we could do was to set up the patients with a telephone appointment and to ask them to self-quarantine until receiving instruction from a provider.”

He is also concerned about the shortages of basic protective equipment and masks.

“We’re going to lose whole groups of health care workers due to illnesses and quarantines during this initial wave of community infections,” Phillips said.

Who will carry the bulk of the costs of the COVID-19 outbreak might also depend on how effective current measures are, an analysis of the insurance companies last week by S&P suggested.

“Most insured individuals, especially in group or employer plans, don’t meet their deductible limits until later in the year,” S&P analysts wrote in a report published March 12. “So if the spread of COVID-19 is limited to the first half of the year, the insured will bear a greater proportion of treatment costs. However, if COVID-19 continues to spread later in the year, when insured individuals have met their cost-sharing requirements, the insurer will bear more of the medical costs directly.”

While some communities and other countries are moving to address potential financial hardships and even bankruptcies that may result from the outbreak, the details on health care provisions for workers without health insurance remain very limited.

There are?other health care experts who are urging the federal government to expand federal provisions and ease Medicaid enrollment by taking measures like “creating a one-page application form and keeping people continuously enrolled without the need for constant recertification” or allowing “states to temporarily increase Medicaid eligibility higher up the income scale in all states beyond their current income limits.”

Until then, a lot of people from the most vulnerable and most exposed sectors, such as food-service workers, may be the least likely to get tested.

“If you don’t have insurance—either you can’t afford insurance or you’re not working—if you did go to get tested, you’re going to have a tough time getting a test that’s free, because the capacity is so low,” Grayson noted. “Then you get stiffed for a bill that’s a couple thousand bucks, and you can’t go back to work if you’ve tested positive. So why would you get tested? You wouldn’t, there is no incentive.”

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