Pandemic intensifies universal health care conversation

>> Sreenivasan: IN A SIGN OF THE ECONOMIC TOLL COVID-19 IS TAKING, MORE THAN THREE MILLION AMERICANS FILED FOR UNEMPLOYMENT BENEFITS LAST WEEK, A RECORD NUMBER. ACCORDING TO THE KAISER HEALTH FOUNDATION, CLOSE TO HALF OF EMPLOYEES RECEIVE HEALTH INSURANCE FROM THEIR EMPLOYER. THAT MEANS MORE THAN 1,500,000 PEOPLE MIGHT NOW BE NOT ONLY OUT OF A JOB BUT WITHOUT HEALTH INSURANCE, AS WELL. AS YOU MIGHT IMAGINE, THAT HAS ONLY INTENSIFIED THE NATIONAL CONVERSATION ABOUT UNIVERSAL HEALTH CARE. I RECENTLY SPOKE ABOUT THAT WITH SARA COLLINS, VICE PRESIDENT FOR

HEALTH CARE COVERAGE AND ACCESS AT THE COMMONWEALTH FUND. SARA COLLINS, THANKS FOR JOINING US. RIGHT NOW, WE HAVE THESE ENORMOUS NUMBERS OF PEOPLE THAT WERE FILING FOR UNEMPLOYMENT, AND THAT NUMBER MAY GROW. AND THE REASON WE'RE TALKING TO YOU ABOUT THIS IS, SO MANY AMERICANS HAVE HEALTHCARE TIED TO THEIR EMPLOYERS. SO, WHAT KIND OF A STRAIN ARE WE GOING TO SEE ON THE HEALTHCARE SYSTEM AND ON THE SAFETY NET IN THE NEXT FEW WEEKS? >> YOU KNOW, IT'S A REALLY MAJOR LOSS OF JOBS-- UNPRECEDENTED,

ACTUALLY-- IN TERMS, IN TERMS OF THE NUMBER OF AN INCREASE AND WILL BE AN UNPRECEDENTED LOSS OF PEOPLE WITH EMPLOYER-BASED COVERAGE. MOST PEOPLE GET THEIR COVERAGE THROUGH-- THROUGH AN EMPLOYER, SO THAT'S A BIG HIT TO THE HEALTH INSURANCE SYSTEM AND TO PEOPLE WHO ARE NOW COVERED THROUGH EMPLOYER-BASED PLANS. >> Sreenivasan: WHAT ABOUT THE FAILSAFE SYSTEMS THAT WE HAVE IN THE AFFORDABLE CARE ACT OR THE MEDICAID EXPANSION? >> THIS IS A REALLY IMPORTANT PROTECTION NOW THAT WE HAVE THAT WE WOULDN'T HAVE HAD TEN YEARS AGO HAD IT NOT BEEN FOR THE

AFFORDABLE CARE ACT. SO, IF YOU LOSE YOUR JOB AND YOU HAVE COVERAGE THROUGH YOUR JOB, YOU ARE ELIGIBLE AUTOMATICALLY FOR A SPECIAL ENROLLMENT PERIOD THROUGH THE A.C.A. MARKETPLACES. SO, IT'S-- WHAT'S REALLY IMPORTANT FOR PEOPLE TO DO RIGHT NOW IS TO GO TO healthcare.gov AND CHECK OUT YOUR OPTIONS THROUGH THE MARKETPLACES. YOU MAY ALSO BE ELIGIBLE FOR MEDICAID, SO YOU COULD GET-- YOU MIGHT GET COVERAGE THROUGH MEDICAID. BUT IF YOU GO TO THAT WEB SITE, YOU CAN FIND OUT WHAT YOUR

OPTIONS ARE. YOU MIGHT BE ELIGIBLE FOR A SUBSIDY. YOUR INCOME PROBABLY DROPPED, IS DROPPING A LOT, AND SO YOU'RE-- YOU COULD BE ELIGIBLE FOR A SUBSIDY TO OFFSET THE COST OF YOUR PREMIUMS OR BE ELIGIBLE FOR MEDICAID IN YOUR STATE. >> Sreenivasan: DOES WHAT WE'RE LIVING THROUGH NOW SHINE A DIFFERENT LIGHT ON THE CONVERSATION ABOUT UNIVERSAL HEALTH CARE? >> I THINK IT REALLY DOES. THERE ARE ABOUT 30 MILLION PEOPLE THAT ARE STILL UNINSURED. AND SO, YOU'RE SEEING IN CONGRESSIONAL BILLS ATTEMPTS TO PATCH THAT UP BY COVERING THE COSTS, REQUIRING INSURERS TO

COVER THE COSTS OF TESTING, FOR EXAMPLE. WE'RE CONSIDERING OTHER OPTIONS. 11 STATES HAVE NEW SPECIAL ENROLLMENT PERIODS FOR THE MARKETPLACES SO THAT PEOPLE CAN GET ENROLLED WHO ARE UNINSURED. AND WE'RE LIKELY TO SEE A NATIONWIDE EFFORT TO OPEN UP THE MARKETPLACES FOR PEOPLE. BUT I THINK THAT THIS SHOULD BE A BASELINE FEATURE OF OUR HEALTHCARE SYSTEM. WE SHOULD KNOW GOING INTO A CRISIS LIKE THIS THAT EVERYONE HAS HEALTH INSURANCE COVERAGE. WE'RE NOT TRYING TO INSURE PEOPLE TO PROTECT THEMSELVES

FROM CATASTROPHIC HEALTH CARE COSTS. THIS IS A VERY SERIOUS ILLNESS, AND IF PEOPLE END UP IN THE HOSPITAL WITHOUT INSURANCE, THEY'RE GOING TO FACE MAJOR BILLS. IF THEY CAN'T PAY THOSE BILLS, THEN THE HOSPITALS ARE GOING TO HAVE TO FIND A WAY TO COME UP WITH THE FUNDING TO PAY THOSE BILLS. AND I THINK IT'S GOING TO-- IT'S A RECKONING FOR THE UNITED STATES TO LOOK CLOSELY AT HOW WE CAN EXPAND COVERAGE TO GET TO UNIVERSAL COVERAGE, AND THERE ARE LOTS OF WAYS WE CAN DO THAT. VICE PRESIDENT BIDEN HAS PROPOSED BUILDING ON THE AFFORDABLE CARE ACT TO GET TO

UNIVERSAL COVERAGE. SENATOR SANDERS HAS PROPOSED MEDICARE FOR ALL. THESE ARE VERY DIFFERENT PATHS, BUT THEY ULTIMATELY LEAD TO THE SAME PLACE. >> Sreenivasan: WHAT'S THE BIGGEST THING YOU'RE WORRIED ABOUT? >> I'M VERY CONCERNED THAT PEOPLE ARE GOING TO NOT GET CARE BECAUSE OF THEIR INSURANCE STATUS. I'M WORRIED THAT WHEN THEY DO GO TO GET CARE, THAT THEY'RE GOING TO BE VERY, VERY SICK AND THAT THEY WON'T-- THEY'LL GET MAJOR BILLS AND NOT ABLE TO PAY THOSE BILLS.

AND HOSPITALS ARE ALSO DEEPLY IN FINANCIAL TROUBLE BECAUSE OF THAT, AS WELL. >> Sreenivasan: CONSIDERING THE LEGISLATION THAT CONGRESS HAS ALREADY PASSED, WHAT SHOULD PEOPLE KNOW ABOUT THIS? >> WELL, THEY SHOULD KNOW THAT ALL-- ALL INSURERS AND EMPLOYERS HAVE TO COVER THE TESTS ASSOCIATED WITH CORONAVIRUS, AND IT HAS TO DO WITHOUT COST- SHARING SO YOU WON'T FACE ANY COSTS. AND STATES CAN ALSO COVER PEOPLE WHO ARE UNINSURED THROUGH THEIR MEDICAID PROGRAMS AND FOR THE

COSTS OF TESTING. BUT, IMPORTANTLY, THIS DOES NOT INCLUDE TREATMENT. SO, IF YOU GET-- IF YOU GET SICK AND YOU'RE UNINSURED, YOUR TREATMENT COSTS AREN'T COVERED. SO, THAT'S A GAP THAT NEEDS TO BE-- STILL NEEDS TO BE ADDRESSED. SO, ONE THING THE ADMINISTRATION COULD DO IS TO EXPAND THAT COVERAGE FOR TESTING TO TREATMENT THROUGH THE MEDICAID PROGRAM. MEDICAID IS AN INCREDIBLY FLEXIBLE PROGRAM IN A CRISIS. IT'S OFTEN DRAWN ON FOR-- TO

RESPOND TO NATURAL DISASTERS OR EPIDEMICS LIKE THIS. AND THE ADMINISTRATION COULD DO MUCH MORE THAN IT'S DOING WITH MEDICAID, WITH THE MEDICAID PROGRAM RIGHT NOW, TO HELP PATIENTS AND ALSO HOSPITALS THAT THEY'RE GETTING CARE FROM. >> Sreenivasan: SARA COLLINS OF THE COMMONWEALTH FUND, THANKS SO MUCH FOR JOINING US. >> THANK YOU.