Virtual Doctor Visits and “Social Distancing:” Early Legislative Reactions to the Coronavirus

Handshaking is being discouraged as social distancing takes effect in Washington and elsewhere.

In the past week, we’ve seen three main categories of legislative reaction to the coronavirus.

First, there’s government activity targeted toward the current clinical dilemma: that is, the testing, treatment, and slowing of the virus itself.

Second, there’s legislation that addresses downstream consequences – and, in this group, we can include the question of who is going to pay for the testing and treatment, and how. Government action that mitigates broader negative economic effects of the virus would also be in this group.

The third category has already been given a friendly government euphemism: “social distancing.” This type of legislation would be government-imposed restrictions on the movement and meeting of people in order to slow the virus. Serious, First-Amendment stuff.

In the first category, last week Congress and the administration broke some speed records by introducing, passing, and signing a coronavirus funding package into law in less than three days. The package provides $8.3 billion in funding, quite a jump from the one-and-a-quarter billion in new funds for which President Trump had originally asked.

The funding package is directed toward vaccine development and additional supplies – and state, local, and even international activities aimed at stopping the spread of the virus.

What was not funded, at least in this package, was the medical care that will be necessary to test and treat patients. For example, hospitals did not see any money in this funding bill, as requested by the American Medical Association (AMA) and American Hospital Association (AHA) last week.

For the second category, government activity addressing downstream consequences of the virus, we have to go to the state level: specifically, Washington State, which appears to be among the states most affected by the virus at this point. Compared to the recent federal funding package, Washington and other states’ actions have concentrated on who is going to pay for testing and treatment of the virus, and how.

This past week, Washington State passed a $100 million funding package, again, in record time. The funding package provides for free testing for patients who do not have health insurance. For those that have insurance, the Washington State’s insurance commissioner put out an order to insurers that patients will not have to pay out-of-pocket for any testing of the virus. Similar orders have been put in place in California and New York, and America’s Health Insurance Plans (AHIP) on Friday fell in line, announcing its own emergency plan, whereby most of the national carriers will waive out-of-pocket costs for testing across the country.

The third category of legislation, “social distancing,” is what the Italian government did this past weekend to a third of its population, with the provisions ultimately being extended to the entire country: restricting the movement and meeting of people to keep the virus from spreading.

Political leaders in Washington State are clearly contemplating it. The state’s governor recommended that meetings of more than 10 people be postponed or conducted virtually. As of yet, however, neither the federal government nor any of the states have put forward any mandatory “social distancing” requirements.

There have been times in recent history when, after a dramatic event, we have seen rapid changes in the way we go about our day, and legislation is sometimes the principal force behind those changes. For example, as a result of 9/11, state and federal legislation, helped by technological advancement, pushed society away from paper checks toward electronic payments, ushering in an era of virtual money (and a generation that doesn’t know what a wallet is).

It’s early yet, but in response to the coronavirus, we’re already seeing cultural shifts in how people meet and interact. Last week, as in meetings across the country, there was no shaking of hands on Capitol Hill – and it wasn’t due to partisan acrimony. Congressional staffers weren’t even accepting business cards, as a precaution against spreading the virus.

What will be interesting is how legislation may change the way we deliver healthcare. As an example, long before coronavirus, there was already interest in telehealth, but current state bills being considered, the Centers for Medicare & Medicaid Services (CMS) announcement on Friday about Medicare-funded “virtual check-ins,” and AHIP’s emergency plan last week are all pushing telehealth forward with obvious urgency.

It will be interesting to see how government actions are taken today in response to the coronavirus will shape our medical care tomorrow.  

Programming Note: Listen to legislative updates with Matthew Albright every Monday on Monitor Mondays, 10-10:30 a.m. EST.

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Matthew Albright

Matthew Albright is the chief legislative affairs officer at Zelis Healthcare. Previously, Albright was senior manager at CAQH CORE, and earlier, he was the acting deputy director of the Office of E-Health and Services for the Centers for Medicare & Medicaid Services.

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