Coronavirus could mean hefty medical bills for California’s uninsured
Norma Duarte, a 46-year-old stay-at-home mother of three in Mendota, does not have health insurance. Neither does her oldest son, 19, nor her 42-year-old husband.
Duarte’s husband used to work for a pesticide company and made around $40,000 a year – just “enough to pay the bills,” she said. He lost his job a little more than a month ago. She worries about what might happen if someone in the family falls sick.
The Duartes are not alone.
Although elders are considered most vulnerable to the coronavirus, medical professionals have been surprised at the toll the virus has taken on younger adults. According to the Centers for Disease Control and Prevention, Americans aged 19 to 54 account for nearly 40% of hospitalizations related to coronavirus.
Nearly 15% of American adults in that age group lack health insurance, a McClatchy analysis of U.S. Census Bureau data found.
According to the census data, outsized shares of those uninsured, work in sectors like entertainment, tourism and food services, retail services, teaching and social services and construction – professions that have not only been adversely impacted by the outbreak but may be more vulnerable to the coronavirus since they require close physical proximity with other people or the use of common surfaces accessed by multiple people.
State-level census data also show that in states like Florida and California, where the spread of contagion has been severe, the number of residents aged 19 to 54 who are uninsured number around 2.7 million and 2.8 million respectively. That’s around 13% of Florida’s population and 7% of California’s.
Kristin Burnett, a resident of Sarasota, Florida, is in her mid-thirties and suffers from an auto-immune disease. She used to be a restaurant manager and worked around 70 hours a week a year ago. She left that job to look after her ailing father.
Now she works around 20 hours a week. She declined to say what she currently does.
She said that with the pay she has now, she cannot afford private insurance.
“It’s a scary thought to think we might have to spend $500 just for a medical appointment,” she said.
Overall, roughly 30 million people of all ages nationwide have no form of health insurance coverage, McClatchy’s analysis found.
Studies have shown the coronavirus to be particularly dangerous for older patients. According to a March 18 CDC study, around half the ICU admissions and 80% deaths recording in the United States occurred among people above the age of 65. This finding is similar to data from China, which indicates that most deaths occurred among people above 60.
McClatchy’s analysis of the census data revealed that more than 3.7 million American residents above the age of 55 – around 5% of that age-group – lack coverage. Around 2% of U.S. residents aged 65 and up, nearly 400,000 people, are uninsured.
$35,000 bill
While costs will vary, recent news reports suggest that getting tested and treated for coronavirus can much as high as $35,000 for uninsured patients, painting a devastating picture for those U.S. residents without health coverage – nearly a tenth of the U.S. population.
Even those who are insured could face high costs associated with coronavirus treatment.
A recent study by the Kaiser Family Foundation estimates that the average cost of coronavirus treatment for someone with employer insurance can range from $9,000 to $20,000 depending on the severity of the case and whether complications arise.
States have responded to this crisis in different ways. Some like California and Maryland have issued directives to expand coverage and reduce cost-sharing for cases related to COVID-19. Others like Florida and Missouri have issued bulletins encouraging insurers to cover coronavirus-related costs but not making it mandatory.
The Families First Coronavirus Response Act passed by Congress on March 18 requires health insurers to cover the cost of testing for COVID-19 cases but has no provision for coverage of treatment once a patient has been diagnosed to have the virus.
“Individuals may receive primary healthcare services at their local health center at reduced cost or free of charge depending on their economic status,” the Department of Health and Human Services said in a statement to McClatchy.
HHS declined to outline a specific plan when asked about treatment for the uninsured.
Dire straits
At the state level, Texas leads the nation with around a quarter of its residents aged 19 to 54 without health insurance coverage. It is closely followed by Oklahoma at 22% and Florida with around 21%.
Thirteen percent of the residents belonging to that age group in California are uninsured.
Among them is Leonel Ochoa, a 26-year-old farm laborer from Mendota. He estimates he makes around $2,300 a month and he lives with his parents but contributes to paying the household’s bills. His monthly expenses are about $1,800 – leaving only around $500 as savings.
He constantly worries about falling ill from the virus, he said. The rest of his family members have some level of health care coverage.
“I have nothing,” he said.
Ochoa said he’s been uninsured for a while now because private health insurance is beyond his budget. But he continues to look around to see if he can find an affordable option.
Among American workers lacking insurance, nearly 18% are employed in professions related to entertainment, recreation and food services, around 13% in retail and 12% in educational, health care and social services.
Work in these sectors requires people to be in close social contact with others, increasing the risk of contracting the virus.
In California, around 11% of uninsured workers belong to the retail industry and around 16% are in the arts, tourism and related services.
In Florida the shares are even higher. Around 14 percent of the uninsured work in retail and nearly a fifth of uninsured workers are employed in the arts, recreation, tourism and other related services.
According to the census data, the annual median income – the midpoint of all incomes – of an uninsured individual in the United States is around $22,000, well below the national median of $35,000. To add to this, the global economic volatility caused by the pandemic has already led to record job losses.
California’s Health Department encourages those who are uninsured and eligible to apply for Covered California and Medi-Cal.
“During the ongoing outbreak of COVID-19, California has taken multiple steps to ensure that uninsured Californians have access to healthcare and, if needed, testing,” the California Health Department said in a statement.
Health care advocates say that more should be done at the federal level to expand coverage across the nation.
“Congress and the administration should rapidly expand every program available to get everyone covered,” said Caitlin Donovan of the National Patient Advocate Foundation, a non-profit advocacy group.
“The last thing we want is for people to avoid proper treatment and die at home because they made a healthcare decision based on their bank account.”
Donovan’s advice to those who don’t have health insurance but need treatment: Apply for retroactive Medicaid coverage, look for financial aid at the hospital itself or from charities and check to see if you are eligible for housing or nutritional assistance to offset the cost of medical bills.
‘I would have no idea what to do’
Duarte, the mother of three children in Mendota, said that if she or one of her other uninsured family members fell victim to COVID-19, they would look around for programs that might help people who are uninsured. But at the moment, they have no alternatives.
“That is what worries me right now – the health insurance and that someone in the house will get sick,” Duarte said.
“Imagine? I would have no idea what to do, honestly I don’t.”
McClatchy’s White House correspondent Michael Wilner and congressional correspondent Emma Dumain contributed to this report. The Sacramento Bee’s Cathie Anderson and Fresno Bee’s Manuela Tobias also contributed.
This story was originally published March 30, 2020 at 1:53 PM.
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