On March 18, 2020, the President signed the Families First Coronavirus Response Act, or HR 6201, into law. It includes important requirements for both public and private insurance to provide access to testing for COVID-19 and testing-related services without out-of-pocket costs.
The new law creates several important decisions for Texas Governor Abbott to make. These decisions should be made as quickly as possible, because the health of our entire state depends on every Texan being able to access testing. An essential component to the best public health response to COVID-19 is to remove all financial barriers to testing. Testing is key to tracking and containing the spread of the virus.
The new law can make that possible, but Governor Abbott must take actions to bring this help to Texans.
1. Implement the automatic 6.2 percentage point increase in our federal Medicaid matching funds, retroactive to January 1, 2020 and lasting through the last day of the calendar quarter in which the emergency ends. To qualify for the funds, Texas Medicaid must adjust systems to ensure no Texans loses Medicaid during the emergency. Texas’ 2020 Federal Medical Assistance Percentage [FMAP]is currently 60.89; this provision would increase it to 67.09.)
2. Opt into special 100% federally-funded testing for the uninsured, administered through Medicaid.
3. Opt into and implement as soon as possible special 100% federally-funded testing for the uninsured paid for by the National Disaster Medical System, to ensure testing for non-citizens. This funding would support testing without regard for immigration status. Texas must avoid the dangerous public health consequences if a large share of the population were left out of testing and tracking of the disease.
Roughly 1 in 5 uninsured Texans could be excluded from the Medicaid-linked COVID-19 option due to immigration status, depending on the final interpretation of the new law. But, HR 6201 also allocates $1 billion nationwide for that fund that Texas can use to ensure there are no barriers to testing for non-citizens. These funds are available in addition to the uncapped Medicaid-linked funding for testing.
4. Fill remaining gaps to ensure free COVID-19 testing for Texans with private insurance. The newly-passed Families First Coronavirus Response Act takes a vital step by covering the costs of COVID-19 testing to uninsured Texans, as well as those in Affordable Care Act-compliant insurance, self-insured plans used by many governments and larger businesses. These include plans “grandfathered” under the ACA, Medicaid, the Children’s Health Insurance Program (CHIP), Medicare, TRICARE, Veterans Affairs, coverage for federal civilians, and the Indian Health Services.
However, this provision of the new federal law does not apply to some bare-bones insurance and non-insurance coverage sold to Texans.
We applaud the Governor’s earlier request for state-regulated insurers to do the same, and urge his administration to take all additional steps needed to ensure that all of Texas’ state-regulated plans are held to the same high standard of coverage of testing, without out-of-pocket costs, including testing-related costs like office visits or facilities fees, and with no surprise bills.
The Governor should also ensure that any bare-bones, temporary, and non-insurance plans that are not required to cover testing with no out-of-pocket costs immediately inform their customers and provide them with information on how to access free testing for the uninsured.
Advocates for Texans with disabilities and from a broad spectrum of special health care needs have shared their particular urgent priorities, and doctors and hospitals are communicating directly with Texas Medicaid and the governor to make them aware of critical needs.
CPPP is working closely with our coalition partners at Texans Care for Children and Children’s Defense Fund Texas to identify urgent needs and best practices to remove barriers to Texans’ access to testing and treatment.
1. This brief from CPPP presents a detailed list of priorities in order of urgency.
2. We have also joined with partner organizations to submit this letter to Governor Abbott, Texas Health and Human Services Commission (HHSC), and the Texas Department of Insurance (TDI).