After the Supreme Court delivered a major blow to his pandemic policies, President Joe Biden does not seem done with federal mandates. The new rule, which took effect this weekend, requires insurance companies to cover the costs of in-home tests. However, according to the New York Times, many insurers are balking that the mandate asks the impractical in the short term and will only create months of frustration for citizens. Indeed, one executive said it would send companies back to the old “shoe box days.”
Biden acted unilaterally to order companies to cover the costs of eight at-home tests per month. The problem is that such a guarantee requires a new system for these companies in covering over-the-counter tests as opposed to things like doctor visits. The latter are already part of a unified computer system with billing codes.
The Biden mandate will require companies to process receipt-based claims. Ceci Connolly, president and C.E.O. of the Alliance of Community Health Plans described it as “taking things back to the olden days, where you’ll have a person throwing all these paper slips in a shoe box, and eventually stuffing it into an envelope and sending it off to a health insurer to decipher.”
The controversy is particularly interesting after the mandate rulings. The justices in the major OSHA ruling ruled that “major questions” like a vaccine mandate should be resolved through the legislative process. As stressed by Justice Neil Gorsuch in his concurrence: it is a matter of “who decides”:
Why does the major questions doctrine matter? It ensures that the national government’s power to make the laws that govern us remains where Article I of the Constitution says it belongs—with the people’s elected representatives. If administrative agencies seek to regulate the daily lives and liberties of millions of Americans, the doctrine says, they must at least be able to trace that power to a clear grant of authority from Congress.
The tests are different from the major question of a national vaccine mandate. This is more of an agency decision in determining what is covered. However, the lack of preparation and process are indicative of the improvisational character of many of these new mandates. The legislative process allows such changes to be reviewed both from a policy as well as a process standpoint.
I do not believe that this rule is unconstitutional or an “executive overreach,” as suggested by some. However, it shows how such mandates can satisfy immediate political needs without addressing the logistical problems downstream. If these executives are correct, the public is likely to face difficulties in getting reimbursement for months. If the agencies order faster outlays, it is likely to increase fraudulent or erroneous payments.
There remain serious questions of why the Biden Administration did not act earlier on tests or, even more importantly, therapeutics with the likelihood of variants emerging. That includes creating a system for such reimbursements for tests. That will hopefully be the subject of bipartisan oversight, which is increasingly rare in our current political environment.