THE PROGNOSIS

Health insurers spent the last year under a harsh spotlight, as Congress sought to prevent the surprise medical bills these companies and medical providers often slap on American patients. 

As coronavirus spreads quickly across the U.S., these companies see a chance to score some points with the public — and the Trump administration. 

The nation’s top health insurers met with President Trump, Vice President Pence and other health officials yesterday, and stressed they would waive co-payments on coronavirus testing and cover treatment for those infected with the virus.

Anthem chief executive Gail Boudreaux said the industry has been focused on ensuring access to care “from day one.”

Justine Handelman, a vice president for Blue Cross Blue Shield, said the firm is “pleased to make sure people have access to the test, to the coverage they need.”

Humana chief executive Bruce Broussard said he is focused on ensuring seniors on Medicare plans can get tested as easily as possible.

And Matt Eyles, president of the industry trade group America’s Health Insurance Plans, told Trump this: “We all have the same commitment to making sure that cost is not a barrier to people getting tested and treated.”

Health insurers have resisted several measures proposed in Congress to protect consumers from the “surprise” medical bills they can get after visiting an out-of-network emergency department or an out-of-network provider at an in-network hospital. The administration has also focused on the systemic problem, calling for reforms to hold patients harmless from these types of bills. 

But administration officials just heaped praise on health insurers for taking action to get more Americans tested. Pence said the insurance companies' pledges to make coronavirus testing and treatment free would cover almost 240 million Americans. He said that includes both private plans as well as coverage these companies sell by contracting with Medicare and Medicaid. 

“I know I speak on behalf of the president when I say how grateful we are for the collaborative spirit, the generosity, and the partnership represented by the great companies at this table,” Pence said, noting also that more than 4 million tests will become available this week after delays caused by technical problems. 

Still, health experts have warned it's not always as simple as promising to make coronavirus testing and treatment free, given the country's complex medical billing system.

Larry Levitt, a vice president at the Kaiser Family Foundation:

The Blue Cross Blue Shield Association, which is a top seller on the Affordable Care Act marketplaces, has offered some details, saying it will waive prior authorization for coronavirus diagnostic tests and already-covered services that are medically necessary if someone has the virus. The insurer also said it won't charge cost-sharing to members for getting tested.

Humana has also promised to waive out-of-pocket costs for getting tested for all patients in employer-sponsored plans as well as the Medicare Advantage plans and Medicaid plans the company sponsors. It is also waiving telemedicine costs for all urgent care for the next 90 days.

Aetna has made similar promises, along with announcing all of its patients diagnosed with coronavirus will receive a care package.

“The scarcity of testing has emerged as a crucial challenge to the U.S. response to the coronavirus outbreak, with health providers, public officials and individuals all calling for more widespread testing capacity,” The Post's Carolyn Y. Johnson and Mike DeBonis write. The unavailability of tests makes it difficult to determine how many Americans are infected with the disease."

— Here are two people who have gotten tests: Reps. Matt Gaetz (R-Fla.) and Mark Meadows (R-N.C.), the latter of whom Trump named last week as the next White House chief of staff. They have both tested negative for coronavirus. Both men had self-quarantined after contact with a coronavirus carrier at the annual Conservative Political Action Conference last month.

— The administration is racing to develop contingency plans that would allow hundreds of thousands of employees to work remotely full time, my colleague Lisa Rein reports.

“The Office of Personnel Management, which oversees policy for the workforce of 2.1 million, has urged agency heads in recent days to ‘immediately review’ their telework policies, sign paperwork with employees laying out their duties, issue ­laptops and grant access to computer networks,” Lisa writes.

“The administration has not issued a widespread mandate, but some offices already have acted. The Securities and Exchange Commission late Monday became the first federal agency in Washington to clear 2,400 employees from its headquarters after discovering that an employee might be infected.”

— A shortage of specialized masks has prompted federal health officials to loosen their recommendations on the face protection that front line health-care workers should use to prevent infection from the virus, The Post's Lena H. Sun reports.

“Instead of recommending that health-care workers use specialized masks known as N95 respirators, which filter out about 95 percent of airborne particles, the Centers for Disease Control and Prevention posted new guidelines Tuesday that said ‘the supply chain of respirators cannot meet demand’ and that looser fitting surgical face masks ‘are an acceptable alternative,’” Lena writes.

— Stopping the virus is no longer the goal. It’s to slow it down. The United States is at a make-or-break moment that depends on what's known as “social distancing.”

“The best way to prevent a catastrophic explosion of new cases in the next few weeks, many experts think, is to break potential chains of transmission by preventing sick people from coming in close contact with healthy ones, whether it means canceling conferences or relying on individual decisions to avoid crowded public transportation or postpone weddings,” The Washington Post's Carolyn Y. Johnson, Lena H. Sun and Andrew Freedman report.

“… The city of Austin canceled its South by Southwest festival. San Francisco has called off the ballet, the symphony and other gatherings for the next two weeks. Boston canceled its St. Patrick’s Day parade. In Washington state, where 20 people have died in King County, the health department is urging people to avoid large gatherings ‘if you can feasibly avoid bringing large groups of people together.’”

— The continued spread has sent schools and offices across the country scrambling, with many closing or asking students and employees to work remotely until further notice. Here are a few of the notable closures: 

  • Harvard University advised students not to return to campus after spring break and to work remotely until further notice. Amherst College is switching to online instruction. Princeton University said classes will be held online, and students are being encouraged to stay home after spring break.
  • PhRMA, the drug industry’s top lobbying group, announced it will close its D.C. headquarters for the rest of the week because an individual exposed to the coronavirus visited the group’s office last week, Stat News reports.
  • The Coachella Valley Music and Arts Festival was postponed from April to October.

MSNBC host Chris Hayes:

— What's the coronavirus's fatality rate? It depends on the age range.

It has proved especially deadly for the elderly — an estimated 21.9 percent in China for patients over the age of 80, according to the World Health Organization.

But here's the good news: Unlike the seasonal flu, which most often affects the very young and very old, young children have been virtually untouched by the novel virus. “In China, only 2.4 percent of reported cases were children and only 0.2 percent of reported cases were children who got critically ill,” The Post's William Wan and Joel Achenbach explain. “China has reported no case of a young child dying of the disease covid-19.”

“With respiratory infections like this, we usually see a U-shaped curve on who gets hits hardest. Young children at one end of the U because their immune systems aren’t yet developed and old people at the other end because their immune systems grow weaker,” Vineet Menachery, a virologist at the University of Texas Medical Branch, told William and Joel. “With this virus, one side of the U is just completely missing.”

The fatality rate is also low for teenagers and young and middle-aged adults. In China, it is roughly 0.2 percent for people ages 10 to 39. China has touted its efforts to bring the outbreak swiftly under control, but the real story is more complex, writes University of Chicago professor Dali L. Yang. “Although China’s national authorities acted decisively after Jan. 23, there were key deficiencies at the outset,” he explains.

STATE SCAN

— Former vice president Joe Biden took a decisive lead Democratic primary lead over Sen. Bernie Sanders (I-Vt.) last night, with resounding wins in Michigan, Mississippi, Missouri and Idaho while two other states — North Dakota and Washington — continued to count ballots, Sean Sullivan and Matt Viser report.

“It’s more than a comeback. . . . It’s a comeback for the soul of this nation,” Biden said at the National Constitution Center in Philadelphia. "This campaign is taking off, and I believe that we are going to do well from this point on.”

“I want to thank Bernie Sanders and his supporters for their tireless energy and their passion,” Biden added. “We share a common goal, and together, we’ll defeat Donald Trump.”

“The results showed further evidence of the powerful coalition that Biden has assembled to fuel his remarkable turnaround in the past few weeks, particularly black voters who form the backbone of the Democratic Party and the suburban women who helped drive record turnout for Democrats in the 2018 elections,” my colleagues write.

Once again, health care was the top issue for Democrats voting yesterday, according to preliminary exit polls conducted by Edison Research. 

“It has consistently been the top issue among the four issues offered in exit polls throughout this year’s Democratic primaries,” our polling colleagues report. “Over 4 in 10 primary voters in Michigan, Mississippi and Missouri cited health care as the most important issue. It was cited at the top issue by a smaller share in Washington state, nearly 4 in 10.” 

But Sanders's agenda is polling well, even if he isn't. Majorities of Democratic voters in every key state have said they supported ‘a government plan’ that would replace all of private health insurance.

AHH, OOF and OUCH

AHH: Former president Barack Obama marked the 10-year anniversary of the passage of the Affordable Care Act with a video touting the law’s benefits.

“With your help, it was the closest we’ve ever come to universal coverage in America. There are people alive today because of what you did,” he said in the 90-second video from Protect Our Care. “… That’s something worth celebrating, but it’s also progress worth protecting.” 

The clip cites the efforts by Republicans trying “both in Congress and in the courts” to undermine the law. It follows the recent announcement from the Supreme Court that it will review a federal appeals court decision that found part of the ACA unconstitutional. 

“So even as we celebrate, we commit ourselves to protecting the progress we've made until we finish the job for good with quality, affordable coverage for every single American,” Obama added.

OOF: Two private equity firms trying to influence legislation to end surprise medical billing have contributed heavily to the leaders of the House Ways and Means Committee, according to a report by the liberal consumer advocacy group Public Citizen, provided first to The Health 202. 

The firms WCAS and Blackstone, together with employers and political action committees of health-care companies in WCAS's portfolio, have contributed $335,400 to the campaign committees and leadership PACs of the panel's ranking Republican, Rep. Kevin Brady (Tex.), and $55,800 to Chairman Richard Neal (D-Mass.), the group found. Ninety-five percent of the contributions have been made since 2016. 

Both firms own or invest in companies that have tried to shape or kill surprise billing reforms. These companies, some of which operate through the front group Physicians for Fair Coverage, characterize an approach to resolving surprise bills by tying them to an in-network benchmark price as “government price-fixing.”

“They are deluging key lawmakers with campaign contributions to try to convince the lawmakers to do their bidding,” the report says.

What surprise billing legislation have Brady and Neal proposed in the Ways and Means Committee? A measure that rejects benchmarking in favor of arbitration between doctors and insurers to resolve surprise medical bills — an approach widely perceived as friendly to doctors.

OUCH: Read this before you take your next snack break: If a healthy person consumes the common artificial sweetener sucralose alongside carbohydrates, it can make them gain weight and negatively affect their overall health, our Post colleague Laura Reiley reports. 

That’s according to a study published in the journal Cell Metabolism by a group of Yale researchers on the effects of the sweetener, which is found in Splenda, Zerocal, Sukrana, SucraPlus and other brands.

The sweetener on its own seems fine, but there was a change when combined with carbohydrates. 

Researchers examined “60 healthy-weight individuals and separated them into three groups: A group that consumed a regular-size beverage containing the equivalent of two packets of sucralose sweetener, a second group that consumed a beverage sweetened with table sugar at the equivalent sweetness, and a third control group that had a beverage with the artificial sweetener as well as a carbohydrate called maltodextrin.” 

— And here are a few more good reads:

INDUSTRY RX

Paredox Therapeutics claimed Charles River Laboratories failed to supervise the employee who sent a video to the Humane Society of the United States.
Stat

AGENCY ALERT

10 years after the passage of the Affordable Care Act which was intended to give patients less costly options, more work remains to be done.
Roll Call

HEALTH ON THE HILL

California state officials said on Tuesday they were ordering a major Christian group to stop offering an alternative to health insurance, joining several states scrutinizing these cost-sharing programs that provide limited coverage.
New York Times

REPRODUCTIVE WARS

he Kentucky House passed a bill Tuesday seeking to amend the state constitution to specifically state that women do not have a legal right to an abortion.
Louisville Courier Journal

DAYBOOK

Today

  • The House Oversight and Reform Committee holds a hearing on coronavirus preparedness and response.
  • The House Appropriations subcommittee on agriculture, rural development, the Food and Drug Administration and related agencies holds a hearing on the FDA budget request for fiscal year 2021.
  • The House Ways and Means subcommittee on worker and family support holds a hearing on “Combatting Child Poverty in America."

SUGAR RUSH