House Speaker Nancy Pelosi and Treasury Secretary Steven Mnuchin appear to be negotiating a Covid-19 emergency aid bill that would impose a new Covid-19 testing benefits mandate on self-insured employer health plans as well as on fully insured group health plans.
Pelosi, a Democrat, said late Thursday, during remarks to reports, that one key goal of the bill is to remove barriers to testing for severe acute respiratory coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19.
“What we’re trying to do is be in a positive vein and go forward, in a way, working together, so we can have people be tested, tested, tested,” Pelosi said, according to a transcript of her remarks provided by the House. “That’s what’s really important.”
- A House documents page that includes a link to the latest version of H.R. 6201 is available here.
- A transcript of the Pelosi press conference is available here.
- An earlier article about H.R. 6201 is available here.
On Wednesday, Pelosi said in statement, “We cannot fight coronavirus effectively unless everyone in our country who needs to be tested knows they can get their test free of charge.”
The House is now in recess. It has put a note on its website saying that the next meeting is subject to the call of the chair.
Sen. Tina Smith, D-Minn., has introduced H.R. 3499, a stand-alone Covid-19 testing benefits bill, in the Senate. That bill has 39 sponsors. All of the sponsors are Democrats, or independents who caucus with the Democrats.
Medicare program 91 administrators said Thursday they’ll pay about $35.91 for SARS-CoV-2 testing done in government laboratories and $51.31 for testing done in other labs.
Self-Funded Plan Basics
Federal regulators let large employers form self-insured health plans, outside the jurisdiction of state insurance regulators, under the Employer Retirement Income Security Act of 1974.
About 58 million people get coverage through self-insured employer health plans, according to Mark Farrah Associates.
Employers, their groups and some insurers have argued that self-funded health plans can often provide better benefits more efficiently than fully insured plans can, because the sponsors can design the benefits without having to comply with 50 separate sets of state benefits regulations.
For years, many state insurance regulators and some insurers have argued that one concern about self-funded plans is that they fall outside the scope of state benefits package standards.
Some of the Affordable Care Act (ACA) benefits standards, such as provisions requiring plans to provide coverage for measles shots and mammograms without imposing co-payments or deductibles on the patients, do apply to self-funded plans.
Other federal and state standards, such as the ACA standards that require individual and small group insurance policies to cover at least about 60% of the actuarial value of a standard health benefits package, do not.
H.R. 6201: The Families First Coronavirus Response Act Bill
House leaders posted a copy of H.R. 6201, the Families First Coronavirus Response Act bill, on a House website Tuesday.