Don’t you want a vaccine? Prepare to pay more for your health insurance
The vaccination rate against covid-19 in the United States is about 60% from 12 years and older. This is not enough to achieve so-called herd immunity, and in states like Missouri, where several counties have vaccination rates below 25%, hospitals are overwhelmed by serious outbreaks of the delta variant, which is more contagious.
About News In Spanish
Noticias en Español is a section of Kaiser Health News that contains translations of articles of great interest to the Spanish-speaking community, and original content focused on the Hispanic population living in the United States.
LET’S TALK ABOUT HEALTH
Vaccine resisters offer all kinds of reasons to refuse free doses and to ignore vaccination efforts. Campaigns urging Americans to get vaccinated for their health, for their grandparents, for their neighbors, or to get free donuts have not worked. States have even held lotteries with the potential to win millions or a college scholarship.
Even so, there are still a large number of unvaccinated people. Federal, state, and municipal governments, as well as private companies, continue to largely avoid mandates for their employees for fear they will provoke a backlash.
So how about an economic argument? Get vaccinated against covid to protect your wallet.
Being hospitalized with covid in the United States usually leads to huge bills. Cases submitted by the same covid patients to the NPR-Kaiser Health News “Bill of the Month” project include a $17,000 bill for a brief hospital stay in Marietta, Georgia (reduced to approximately $4,000 for an uninsured patient under a “charity care” policy).
Also a $104,000 bill for a 14-day hospital stay in Miami for an uninsured man; and a bill of possibly hundreds of thousands for a two-week hospital stay, some of those days on a ventilator, for a foreign tourist in Hawaii whose travel medical insurance had a “pandemic exclusion” clause.
Even though insurance companies negotiate lower prices and cover much of the cost of care, an out-of-pocket bill of more than $1,000 for a deductible, plus copays, and possibly some out-of-network care, should be quite an incentive. scary.
In 2020, before covid vaccines, most major private insurers waived patient payments, from coinsurance to deductibles, for covid treatment. But many, if not most, have allowed that policy to lapse. Aetna, for example, ended that policy on February 28; UnitedHealthcare began rolling back its waivers late last year and ended them at the end of March.
More than 97% of patients hospitalized last month were unvaccinated. Although the vaccines will not necessarily prevent you from getting the coronavirus, they are very effective in ensuring that you will have a milder case and stay out of the hospital.
For this reason, there is the logic behind the reversal of the insurer exemption: Why should patients be kept financially unscathed from what is now preventable hospitalization, thanks to a vaccine that the government paid for and made freely available? free? It is now found in many pharmacies, is showing up at highway rest stops and bus stops, and can be delivered and administered at home in some parts of the country.
A tougher society could impose harsh penalties on people who refuse to be vaccinated and contract the virus. Recently, the National Football League (NFL) decreed that teams will lose a game if a covid outbreak occurs among unvaccinated players, and players on neither team will receive pay.
But insurers could try to do more, such as penalizing the unvaccinated. And there is a precedent. Some policies no longer cover necessary treatment for what insurance companies consider to be risky behaviors, such as scuba diving and rock climbing.
The Affordable Care Act (ACA) allows insurers to charge smokers up to 50% more than non-smokers pay for some health plans. Many states follow that protocol, though most employer-based plans don’t.
In 49 states, people caught driving without car insurance face fines, having their car impounded, losing their license, and even jail time. And reckless drivers pay more for insurance.
The logic behind the policies is that the behavior of those who do not comply with the rules can harm others and cost society a lot of money.
If a person decides not to get vaccinated and develops a severe case of covid, they are not only exposing others in their workplace or neighborhoods; the tens or hundreds of thousands spent on his care could mean higher premiums for others on his same plan next year.
What’s more, outbreaks in regions with little vaccination could help generate more vaccine-resistant variants that affect everyone.
Yes, we often cover people whose habits may have contributed to your illness; Insurance regularly pays for drug and alcohol rehabilitation and cancer treatment for smokers.
Some private insurers are offering people who get vaccinated a credit toward their medical premiums or gift cards and sweepstakes prizes, according to America’s Health Insurance Plans, an industry organization.
Perhaps it would be easier if the Food and Drug Administration gave vaccines full approval, rather than the current emergency use authorization. Still, taxpayer-funded plans like Medicaid and Medicare must treat everyone equally and would face a lengthy process to get federal waivers to experiment with incentives, according to Larry Levitt, executive vice president of KFF.
KFF surveys show that the incentives are of limited value, however. Many of those who refuse the vaccine say they will receive the doses only if their employers require it
But what if the financial cost of not getting vaccinated is too high? If patients thought about the price they might have to pay for their own care, they might reconsider remaining unprotected.