COVID-19 cost-sharing adds a new burden

Once again, America is experiencing a surge in COVID-19 cases, putting a strain on the patchwork American health care system. In parts of the country, familiar scenes are playing out: hospitals are filling up and vital resources like ICU beds and oxygen are in short supply.

But behind the scenes, a new way of paying for and handling the financial burden of COVID-19 care is unfolding. During the first and second surges, private insurers and the US government were picking up the tab for COVID care. But, this summer, we’ve seen COVID treatment costs increasingly transferred to patients. Many insurers are no longer waiving copays and deductibles for COVID care, and employers are asking some employees to contribute more to the monthly costs of their health insurance.

As consumers face direct health care expenses from COVID for the first time, the issue of hidden health care prices, and the many ways inflated health care prices are passed from hospitals to insurers to patients are once again taking center stage. At Sesame — a leader in offering transparent, affordable prices for health care — we are calling on insurers and hospitals to adopt far greater transparency into the costs of COVID treatment. This information on what treatments cost can help consumers make informed choices on everything from how to select the right doctor, hospital, or insurance plan for them, to a better cost/benefit analysis of how vaccination may save them tens of thousands of dollars in avoidable treatment expenses.

For example, a Fair Health study early in the pandemic found hospital charges of nearly $75,000 for a standard COVID hospital stay. And even at the most competitive rates, a lengthy COVID hospitalization could cost nearly $40,000. This information is hard to come by, and varies considerably across the country and even within the same city from hospital to hospital. But these prices are very real, and cause real financial hardship for the millions now receiving bills for care.

Many Americans are under the mistaken impression that these costs are covered — that COVID still enjoys special status under emergency rules, where third parties are footing these bills. Thankfully, vaccines are and continue to be fully paid for by the US government with no planned changes. But COVID-related hospital bills, now that COVID hospitalization is considered largely preventable through vaccination and use of treatments like monoclonal antibodies, no longer come with the same emergency benefits. In our confusing, labyrinthine health care system, this means many Americans dealing with COVID infection are likely to face sky-high medical bills, with no clear up-front understanding of how much they can expect to pay, and when they can expect the charges to stop.

Sadly, transparency and competitive pricing are still on the distant horizon for most of American health care — but a reality for the millions of Americans who use Sesame to find real, affordable prices for care.