Federal Government’s OTC Covid Testing Unfunded Mandate on Commercial Health Plans

This story is an opinion piece written by Dominick Pallone, executive director of the Michigan Association of Health Plans. Read more here. 

Michigan’s insurers have been leaders in the COVID pandemic battle, providing financial support for hospitals and first responders and delivering members information about the importance of vaccination and how to stay safe.

But the demand by the Biden administration that private health plans provide and cover the costs of consumer purchased non-prescribed, over-the-counter COVID tests — a demand that came with only five days’ notice, at a time when those tests are in short supply — is an overreach that will be difficult or even impossible to achieve.

Unfortunately, it also leaves out many lower income families and seniors, as government sponsored health care programs (Medicare and Medicaid) that provide health care coverage to 40% of Americans are exempt from the mandate, creating large inequities and cost disparities in the marketplace.

This new policy will shift costs for public health surveillance to health insurance purchasers, predominantly employers in Michigan, at a time when they can least afford it. For the small business in Michigan that is offering employer sponsored health insurance for its employees and is struggling to keep its doors open during the pandemic, this unfunded mandate could drive their health care premiums to unstainable levels.

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