Vice President Mike Pence said Thursday that the Trump administration is considering using $100 billion that Congress designated for hospital relief to pay for COVID-19 treatment for the uninsured.
"The White House Coronavirus Task Force is working on a proposal for the president to use some of the $100 billion we are making available to hospitals to compensate the hospitals directly for any coronavirus treatment they provide to uninsured Americans," Pence said.
Choosing to use the provider reimbursement fund to pay for treatment for the uninsured instead of reopening enrollment for the Affordable Care Act exchanges could potentially shift costs from insurers to hospitals and siphon hospital funds away from a hotspot like New York toward states that have not expanded Medicaid under the Affordable Care Act such as Florida and Texas.
If the Trump administration doesn't create a special enrollment period, uninsured people who otherwise may have bought insurance on the exchanges, received subsidies, paid premiums and had treatment costs covered by insurers may remain uninsured.
The Federation of Hospitals said that uninsured individuals should not have to worry about paying for COVID-19 treatment, but that the funding should not come out of money Congress set aside in a so-called "Marshall Plan" for hospital surge capacity, protective equipment and lost revenue for providers.
"We need to be reimbursed for care for the uninsured, that's important. But if we don't have up-front resources to keep caregivers on the front line, it's not going to make that much of a difference down the line," said FAH President and CEO Chip Kahn.
HHS has not yet released details about how the $100 billion in provider funds will be distributed, but hospital groups have asked for most of the money to be given directly to hospitals and for it to be distributed quickly.
An HHS spokesperson said Thursday that HHS Secretary Alex Azar is leading an administration-wide policy process to determine how to distribute the funds to make sure the approach represents the "best thinking" across the government.
"It is premature to speak in detail about how these funds will be distributed. Needless to say, the administration will seek to distribute the funds in a way that is fast, fair, simple and transparent," the spokesperson said.
House Speaker Nancy Pelosi (D-Calif.) and Senate Appropriations health subcommittee Chair Roy Blunt (R-Mo.) said they both spoke with Azar on Wednesday about the fund.
The administration is considering a blanket distribution of a significant portion of the funds to hospitals across the country within the next three weeks, Blunt said.
The American Hospital Association told HHS on Tuesday that it wants every hospital across the country to directly and immediately get $25,000 per hospital bed, with additional payments for hospitals in COVID-19 hotspots. The baseline funding request alone would cost $23 billion, the group estimated.
Pelosi said her advice to Azar was to get the money out quickly, and that Congress will make sure HHS has more funds for medical supplies and hospitals if needed.
