34 Time April 6–13, 2020THE COST OF
TREAT MENT
As tens o f thousands fall il l i n the
U.S., patie nts b race for b ig b il ls
BY ABIGAIL ABRAMSWhen Danni askini sTarTeD feeling chesT
pain, shortness of breath and a migraine all at once
on a Saturday in late February, she called the on-
cologist who had been treating her lymphoma. Her
doctor thought she might be reacting poorly to a
new medication, so she sent Askini to a Boston-
area emergency room. There, doctors told her it was
likely pneumonia and sent her home.
Over the next several days, Askini saw her
temperature spike and drop, and she developed
a gurgling cough. After two more trips to the ER,
Askini was given yet another test and again sent
home. She waited three more days for the results,
and on the seventh day of her illness, she at last had
a diagnosis: COVID-19.
A few days later, the medical bills started roll-
ing in. The total: $34,927.43. “I was pretty sticker-
shocked,” Askini says. “I personally don’t know any-
body who has that kind of money.”
Like 27 million other Americans, Askini is un-
insured. Until recently, she had insurance under
Medicaid, which covered her cancer treatment, but
she gave it up when she got a new job in Washing-
ton, D.C., that she was supposed to start in March.
The corona virus outbreak upended those plans,
so Askini has reapplied for Medicaid, hoping her
recent treatment will be retroactively covered. If
not, she’l l be on the hook.
She won’t be alone. P ublic-health e xperts p re-
dict t hat h undreds of thousands and possibly more
than a million people across the U.S. will need t o b e
hospitalized for COVID-19 in the near future. With
unemployment skyrocketing and countless people
losing t heir e mployer-based insurance, Congress
on March 25 was working to reach an agreement o n
a p ackage of aid to individuals a nd businesses—but
health care costs were not a focus of the discussion.
A p reviously passed piece of legislation, the Fami-
lies First Coronavirus Response Act, covered test-
ing c osts b ut d idn’t address the c ost o f t reatment.
While most people infected with COVID-19 will
not require hospitalization, according to the World
Health Organization, those who need to go to the
ICU should brace for big bills—no matter what kindof insurance they have. A new analysis from the
Kaiser Family Foundation estimates that the aver-
age cost of COVID-19 treatment for a patient with
employer-based insurance, and without compli-
cations, would be about $9,763. For a patient with
complications, bills could be about double that:
$20,292. The researchers came up with those num-
bers by examining average costs of hospital admis-
sions for people with pneumonia.
Most private health-insurance plans are likely to
cover the bulk of services needed to treat COVID-
19, experts say. But many insured Americans will
still pay thousands to cover their deductibles,
co-pays or co-insurance costs. More than 80% of
people in the U.S. with employer insurance have
deductibles, and last year the average annual de-
ductible for a single person in that category was
$1,655. For plans purchased by individuals, the
costs are often higher: the average deductible for
a bronze plan in 2019 was $5,861, according to
HealthPocket, a site that helps people shop for in-
surance. Co-pays and co-insurance, meanwhile, are
usually 15% to 20% of the cost for in-network pro-
viders, and much more for out-of-network ones.
All told, patients with employer-based insur-
ance can expect total out-of-pocket costs of more
than $1, 300, the Kaiser researchers found. That
may look like a bargain compared with Askini’s
nearl y $35,000 bill, but with people losing jobs
and the economy grinding to a halt, even a smaller
bill could upend many U.S. families. As it is, nearly
40% of Americans can’t scrape together $400 for
an unexpected expense, according to the Federal
Reserve Board.
Americans on Medicare and Medicaid will face
different challenges. While the cost of COVID-19CORONAVIRUS
^
Congre ss has
mandate d fre e
COVID- 19 te sting
but has not
addre ssed the cost
of getting tre ate dMARK PETERSON—REDUX
HEALTH
WCOST.indd 34 3/25/20 6:11 PM