Viewpoint: At-home COVID-19 test coverage gives providers 'unchecked power' over payers

There's no such thing as free, even when it comes to free COVID-19 testing, writes Cameron Kaplan, PhD, economist and assistant professor of medicine at the University of Southern California’s Keck School of Medicine, in a Feb. 3 Wall Street Journal op-ed. 

Mr. Kaplan writes that despite state and federal mandates requiring insurers to cover a range of COVID-19 tests, the burden of reimbursement placed on insurers gives test providers "unchecked power" to control prices. 

Much of this power comes from lacking restrictions on reimbursement amounts, which pulls more money out of payers' pockets. This is then reflected in rising premiums or reduced benefits, Mr. Kaplan writes. 

He argues that the bulk of the issue is that regular COVID-19 testing isn't a medical service. 

"Regular testing is primarily for the community's benefit," Mr. Kaplan wrote. "Policymakers encouraged testing by making it free for individuals, but leaving insurers to pick up the tab established an inefficient system with hidden costs that are likely to haunt us for years to come."

A solution would be for the government to pay for testing, which it has done on small scales. 

In fall 2021, tests distributed by the Los Angeles Unified School District in fall 2021 averaged $39 a test. That contrasts with the $285 per test his insurance pays for his daughter's weekly preschool testing in 2022.

Alternatively, Mr. Kaplan proposes setting widespread test price caps, such as Medicare's $100 reimbursement limit. 

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