November 23, 2022
  • November 23, 2022

Anti-Vaxers could end up paying more for health insurance

By on August 6, 2021 0

(ABC News) -Covid-19 of America vaccination rate is around 60% for ages 12 and over. That’s not enough to achieve so-called herd immunity, and in states like Missouri – where a number of counties have vaccination rates below 25% – hospitals are overwhelmed by serious epidemics of the more contagious delta variant.

Vaccine resistant offer all kinds of reasons to refuse free vaccines and ignore efforts to get them to get vaccinated. Campaigns urging Americans to get vaccinated for their health, for their grandparents, for their neighbors, or to get free donuts or a free joint have not done the trick. States have even organized lotteries with a chance to win millions or a college scholarship.

And yet there are still a large number of unvaccinated people. Federal, state and municipal governments as well as private companies continue to largely avoid their employee mandates for fear they will provoke a backlash.

So how about an economic argument? Get a covid photo to protect your wallet.

Being hospitalized for covid in the United States usually generates huge bills. Those submitted by covid patients to NPR-Kaiser Health News ‘Bill of the Month’ Project include a bill of $ 17,000 for a brief hospital stay in Marietta, Georgia (reduced to approximately $ 4,000 for an uninsured patient under a “charitable care” policy); a bill for $ 104,000 for a 14-day hospitalization in Miami for an uninsured male; and a bill of up to hundreds of thousands of people for a two-week hospital stay – part of it on a ventilator – for a foreign tourist in Hawaii whose travel health the insurance contained a “pandemic exclusion. “

Even though insurance companies negotiate lower prices and cover a large portion of the cost of care, a bill of over $ 1,000 for a deductible – plus more for co-payments and perhaps some off-grid care – should be a pretty scary inducement.

In 2020, before covid vaccines, most large private insurers waived patient payments – from coinsurance to deductibles – for the treatment of covid. But many if not most have allowed that the policy is obsolete. Aetna, for example, ended this policy on February 28; UnitedHealthcare began canceling its waivers at the end of last year and ended them at the end of March.

Over 97% of patients hospitalized in the past month were not vaccinated. While vaccines won’t necessarily stop you from catching the coronavirus, they are. very effective to ensure that you will have a milder case and that you will not be hospitalized.

For this reason, there is a logic behind the backsliding of insurers: why should patients be financially free from what is now preventable hospitalization, thanks to a vaccine that the government paid for and made available for free? It is now in many pharmacies, it is appearing at rest areas and bus stops, and it can be delivered and administered at home in some parts of the country.

A tougher society could impose stiff penalties on people who refuse vaccinations and contract the virus. Recently, the National Football League decreed that the teams will lose a canceled match due to a covid outbreak among unvaccinated players – and none of the players on the squad will be paid.

But insurers could try to do more, like penalizing the unvaccinated. And there is a precedent. Already, some policies do not cover treatment made necessary by what insurance companies consider risky behavior, such as scuba diving and escalation.

The Affordable Care Act allows insurers charge smokers up to 50% more than non-smokers pay for certain health plans. Four-fifths of states follow this protocol, although most employer plans do not do it. In 49 states, people caught driving without car insurance risk fines, confiscation of their car, loss of their license and even jail. And reckless drivers pay more for their insurance.

The logic behind the policies is that the behavior of offenders can hurt others and costs society a lot of money. If a person decides not to get the vaccine and contracts a bad case of covid, they’re not just exposing others in their workplace or neighborhoods; the tens or hundreds of thousands spent on their care could means higher premiums for others also in their insurance plans next year. In addition, epidemics in areas with low vaccination rates could help reproduce more vaccine resistant variants that affect everyone.

Yes, we often cover people whose habits may have contributed to their illness – insurance regularly pays for drug and alcohol detox and cancer treatment for smokers.

Perhaps this is one of the reasons why insurers have so far also favored carrots over sticks to get people vaccinated. Some private insurers offer people vaccinated with credit for their medical premiums, or gift cards and raffle prizes, depending on American Health Insurance Plans, an industry organization.

Hard love might be easier if the Food and Drug Administration gives the vaccines full approval, rather than the current emergency use clearance. Even so, taxpayer-funded plans like Medicaid and Medicare must treat everyone the same and would encounter a lengthy process to get federal waivers to experiment with incentives, according to Larry Levitt, executive vice president of KFF, an organization. nonprofit focused on health issues. (Kaiser Health News, where Rosenthal is editor, is a program under KFF.) These programs cannot charge different rates to different patients in a state.

KFF vote shows that such incentives are of limited value anyway. Many refractories say they will only be vaccinated if their employers ask them to.

But what if the financial cost of not getting the vaccine is just too high? If patients thought about the price they might have to pay for their own care, they might consider staying unprotected.

Kaiser Health News is a non-profit news service covering health issues. This is an independent editorial program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.