Health Plan Weekly

Bids for the 2021 Medicare Advantage and Part D plan year are due June 1, and new research on the 2020 Annual Election Period (AEP) suggests that seniors are flocking to MA plans primarily because of enhanced supplemental benefits such as over-the-counter (OTC) allowances and dental coverage, as well as $0 premium options, with notable growth in $0 PPO selections. But while lessons from the prior AEP can inform benefit design and marketing approaches for the next enrollment cycle, plans this fall will be challenged by the double whammy of a presidential election and a predicted second outbreak of COVID-19, industry experts observed during a recent webinar hosted by Gorman Health Group (GHG), a Convey Health Solutions company.

Health insurers are encouraging their own on-staff clinicians to volunteer on the front lines of the fight against COVID-19, offering to continue salaries and benefits for those who sign up to help fight the pandemic that has now claimed more than 46,000 American lives.

At the same time, plans are shifting clinical staff members away from cancelled in-person care management and quality improvement activities and toward telephonic care management activities designed to ensure certain members get the help they need, says Michael Lutz, a senior consultant with Avalere Health.

As the COVID-19 pandemic continues to cut a devastating path — medically, socially and economically — across the U.S., signs are emerging that the situation is beginning to take a heavy toll on people’s mental health.

A Kaiser Family Foundation poll conducted March 25 to 30 found that 47% of people who were sheltering in place reported negative mental health effects resulting from worry or stress related to the coronavirus. Similarly, a survey released March 25 by the American Psychiatric Association found that 36% of Americans said the coronavirus is having a serious impact on their mental health.

✦ Covered California, the state’s individual insurance exchange, said 58,400 people had enrolled in plans during its COVID-19-related special enrollment window in the three weeks following March 20. Covered California is also working to expand Medicaid enrollment for the newly unemployed. The agency that oversees the exchange will send out 3.5 million inserts reminding people receiving unemployment insurance that they are eligible for Medi-Cal, the state’s Medicaid program. Read more at https://bit.ly/2VamdiM.

✦ House Democrats on April 14 introduced a bill that would have the federal government pay the entire premium amount for anyone enrolled in COBRA due to a layoff. The Worker Health Coverage Protection Act would also cover the entire premium amount for those furloughed by their employer, until they can return to work. “In the midst of a public health crisis, it is critical that workers and their families maintain access to affordable health care,” Rep. Bobby Scott (D-Va.), one of the sponsors of the bill, said in a statement. Read more about the legislation at https://bit.ly/3esnEk9.

With the novel coronavirus spreading across the nation, both private health insurers and public payers could see heavy economic costs. According to a recent paper prepared by Wakely Consulting Group on behalf of America’s Health Insurance Plans, under the baseline risk scenario with a U.S. infection rate of 20%, allowed costs could range from $112.5 billion to $185.4 billion over 2020 and 2021 combined. As the ultimate number and severity of COVID-19 cases remain unknown, the estimates have a wide range. Graphics below highlight three different organizations’ estimates for how the pandemic will change U.S. health care costs.