Axios Vitals

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June 15, 2020

Good morning.

Today's word count is 1,051, or a 4-minute read.

1 big thing: Surprise medical bills in the coronavirus era

A health care worker tests a woman waiting in a car.

A health care worker tests a woman waiting in a car. Photo: J. Conrad Williams, Jr./Newsday RM via Getty Images

Rep. Katie Porter recently received an explanation of benefits from her insurer saying that, in addition to the $20 co-pay she paid when she got her coronavirus test, she may be on the hook for an additional $56.60.

The catch: The law requires insurers to cover coronavirus testing without cost-sharing. Porter knows that because she voted for it.

Why it matters: Containing the coronavirus depends on knowing who has it, and it's going to be much harder to get people to get tested if they think they'll have to pay for it.

  • But it's becoming increasingly clear that patients may be vulnerable to surprise coronavirus bills.

Between the lines: Porter, who received a coronavirus test on March 23, has insurance through UnitedHealthcare and shared her explanation of benefits with Axios. Congress has required both the test itself and the associated care to be covered without cost-sharing.

  • In a statement, UnitedHealth Group said it has waived member cost-sharing for coronavirus testing and treatment.
  • "Some members received bills early on when there were not yet specific COVID-19 billing codes and during a period in which code adoption was first taking place," the company said, adding that it's waiving those charges and evaluating claims from earlier this year to make sure they were handled correctly.
  • "We are not authorized to talk about [Porter's] specific situation without permission, however, what likely occurred is that her provider used the wrong billing code for the visit," the company added, urging Porter to contact it.

Yes, but: There are plenty of other ways patients could end up with surprise bills.

  • There's a huge question of who should have to pay for coronavirus testing as it becomes more prolific, and many insurers — United included — have said that they'll only cover tests that are "medically necessary," at least without cost-sharing.

What they're saying: "We will not be able to truly reopen and rebuild if Americans rightly fear costly medical bills for visiting their health care providers for coronavirus tests," Porter writes in a letter to top Health and Human Services officials being sent today.

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2. Coronavirus surges across the U.S.

Coronavirus cases and hospitalizations are reaching alarming levels in some states.

What they're saying: "Arizona is the new national hotspot for COVID-19 with more than 4,400 new cases in just the last 72 hours. Per capita, Arizona's infection rate is now more than three times higher than New York state. It's spreading like wildfire," Rep. Greg Stanton tweeted last night.

The big picture: Several states have seen record numbers of new cases over the last few days, including Alabama, Alaska, Arizona, Arkansas, California, Florida, North Carolina, Oklahoma and South Carolina, Reuters reports.

  • On Saturday, Texas reported 2,242 coronavirus hospitalizations — a record for the state, per the Houston Chronicle. Health officials are becoming concerned about hospital capacity.
  • Arkansas, North Carolina and Utah also had record numbers of patients enter the hospital on Saturday, per Reuters.
  • "South Carolina recorded nearly 800 new coronavirus cases on Sunday, setting another single-day record and raising the state’s seven-day average for the 17th day straight," the Post and Courier reports.

The bottom line: There's never been any reason to think that states with mild outbreaks in April weren't at risk of having a crisis in June, especially states that haven't taken lockdowns or social distancing as seriously.

  • "This is not the second wave of the pandemic in states like Arizona, Texas, Utah, California, and Florida. Unlike in New York, the first wave never ended in these places," the Kaiser Family Foundation's Larry Levitt tweeted.

3. The latest in the U.S.

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

Tulsa City-County Health Department director Bruce Dart told the Tulsa World in an interview that he wishes President Trump would postpone his campaign rally on June 20, citing a "significant increase" in coronavirus case trends that could put both the public and Trump himself at risk.

New York Gov. Andrew Cuomo (D) threatened Sunday to reverse New York's phased reopening after the state received tens of thousands of complaints that businesses — particularly bars and restaurants in Manhattan and the Hamptons — were in violation of public health restrictions.

A former data scientist at Florida's Department of Health who helped design the state's coronavirus tracker has created a virus dashboard after being fired from her position in May, the Washington Post reports.

Coronavirus cases in the U.S. are going down — but that's mainly because coronavirus cases in the New York area are going down, Axios' Sam Baker reports.

4. The latest worldwide

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals
Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

France will reopen its borders with other European countries at midnight on Monday after three months of travel restrictions intended to slow the spread of the coronavirus.

Russia's coronavirus death toll for April more than doubled shortly after the World Health Organization questioned how the country simultaneously has the world's third-highest number of cases and such a low mortality rate, the Washington Post reports.

India reported over 11,000 new coronavirus infections on Saturday, a record high that follows a case spike earlier this week of just over 10,900, per Johns Hopkins data.

Beijing has entered "wartime mode," with police guards and lockdowns, after a number of confirmed coronavirus cases tied to the Chinese capital's largest wholesale food market has threatens to unleash a second wave of infections, the Washington Post says.

Brazil has surpassed the United Kingdom to report the most novel coronavirus deaths outside of the U.S., as of Friday evening, per Johns Hopkins data.

5. Bigger risks for shared mobility

Illustration of a driving helmet and goggles with a surgical mask.

Illustration: Aïda Amer/Axios

The coronavirus is creating new health worries and exacerbating economic woes for the whole concept of shared cars, bikes and scooters, Axios' Amy Harder writes.

Why it matters: To what degree our society doubles down on car ownership as the pandemic wears on and, eventually, recedes could have big repercussions for oil demand, climate change and our own daily lives.

By the numbers: What data exists about mobility during the pandemic offers a mixed outlook. But transportation is now the nation's largest source of carbon emissions, so if significant new trends hold, it could matter a lot to climate change and oil demand.

  • All car sales plummeted at the height of America's lockdowns, but used car sales are rebounding fast compared to new car sales, per Reuters.
  • Americans are buying bikes en masse, leading to a shortage, but whether we will actually keep riding them for the long-term is an open question.
  • E-scooter usage in Europe is back to pre-COVID levels.

Threat level: Public transit is the biggest danger when it comes to potential coronavirus spread. Other shared mobility forms present far less risk, though doctors still urge precautions (mask if you’re using a ride-hailing option and thorough cleaning of shared cars, scooters and bikes).

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