Irene Wong isn’t sick. But the 45-year-old Seattle resident, who runs a small travel tour company, has been monitoring the area’s novel coronavirus outbreak anxiously because she doesn’t have health insurance. She’s been wondering about testing and treatment costs that could dissuade uninsured people from obtaining care and thereby help the virus spread.
Local authorities have been talking about that concern. The Washington State Department of Health (DOH) laboratory in Shoreline isn’t billing for COVID-19 tests at this time. Swabs are taken at doctor’s offices or hospitals and then taken to the lab.
“Right now we don’t know how much each test costs, but the public health lab is not charging patients for these tests,” DOH’s website said Wednesday.
Seattle City Councilmember Kshama Sawant on Monday urged Mayor Jenny Durkan and King County Executive Dow Constantine to use emergency funds “to guarantee that anyone in our region with a respiratory illness has access to a doctor’s visit without fear of medical bills.”
The Washington State Office of the Insurance Commissioner (OIC) is reviewing its emergency powers, and Gov. Jay Inslee is looking into the issue, his office said Wednesday. The state House has approved $100 million in funding to respond to the outbreak.
The Wall Street Journal reported Tuesday that the Trump administration was considering using a national disaster program to pay hospitals and doctors for their care of uninsured people who are infected.
People without insurance should consider seeking care at public-health centers and neighborhood clinics, said Katie Ross, a spokeswoman for Public Health — Seattle & King County.
No steps have been taken to date that would help Seattle-area residents pay for care related to COVID-19, other than testing, said OIC spokeswoman Stephanie Marquis.
“It’s not just me. I’ve been thinking about all the other people with no insurance, including homeless people,” Wong said. “The costs could discourage so many people from seeking the appropriate medical attention.”
UW Medicine has received approval to test specimens, and each test will cost about $200, officials said Wednesday. A spokeswoman didn’t immediately say how billing would be handled.
Washington residents may incur additional medical expenses by visiting a doctor’s office, clinic or hospital, such as for tests to rule out COVID-19.
That worries Wong. She dropped her insurance a couple years ago after determining that traveling to Thailand to visit the doctor and dentist would be cheaper, she said.
“Health care is relatively affordable in Asia, but what about here in America? Are people going to stay home and not report their symptoms?” she asked.
People who lack health insurance include some undocumented immigrants, said Aaron Katz, principal lecturer at the University of Washington’s School of Public Health.
“We have people in our community without insurance for a variety of reasons, and it’s well known that a person may avoid care that they would have to pay for,” Katz said.
More than 94% of Washington residents have health insurance, and most plans should cover COVID-19 like any other illness, because insurers must cover treatment considered medically necessary, according to the OIC.
Even people with coverage, however, may think twice about seeking care that could result in co-payments and deductible payments, Katz noted.
“You’re going to have to pay something,” he said. “There are all these impediments in our system that cause people to think, ‘Eh, I’ll hope my illness goes away.'”
Public-health officials have advised people with symptoms like a cough, fever or respiratory problems to call a doctor or clinic first and to visit an emergency room only in critical cases.
People without insurance can check with the Washington Health Benefit Exchange to determine whether they may qualify for Medicaid or Medicare. “Enrollment happens all year long,” said Marquis, the OIC spokeswoman.
“Generally speaking, Medicaid is free insurance,” said Amy Blondin, spokeswoman at the Washington State Health Care Authority. “People on Medicaid should be covered at no cost.”
There are financial counselors on site at Harborview Medical Center in Seattle who can help patients with that, said Susan Gregg, spokeswoman for the hospital.
“When people come in, we don’t ask what insurance they have. We give them the care they need,” Gregg said. “We have a robust program to see whether they qualify for various programs.”
New York Gov. Andrew Cuomo announced a directive Tuesday requiring insurers to waive cost-sharing associated with doctor, urgent care and emergency room visits related to coronavirus testing.
In the Seattle area, the average cost for a 40-minute outpatient visit is $312 without insurance and $162 with insurance, according to FAIR Health, an national nonprofit. For a moderate-severity emergency room visit, the average costs are $227 or $109.
But almost 40% of American adults don’t have enough money saved to cover a $400 emergency, noted Kelly Powers, a board member at the advocacy organization Health Care for All WA.
“The typical out-of-pocket expense for an unexpected major medical event is $1,000,” Powers said.
Some people have been placed under quarantine, but only those who require hospital care are now being quarantined at hospitals, said Chelene Whiteaker, senior vice president at the Washington State Hospital Association.