Expiring subsidies mean some must pay for tests
by Robert Lynch, April 28, 2023
Cayuga Health Systems CEO Martin Stallone made a terrible Freudian slip February 22nd, when he briefed a committee of the Tompkins County Legislature on his hospital giant’s three year partnership with County Government in the fight against COVID-19.
During the month of February, Stallone told the committee, “We actually closed the COVID testing at the mall, with the (testing) totals that I listed before, 2.77 million tests.”
Stallone’s PowerPoint slide at the time stated something different: the closing of a laboratory for test processing on Brown Road near the airport, a couple miles away from the mall.
Cayuga Medical’s public relations spokesperson rushed that afternoon to correct Stallone’s misstatement. This writer retracted his initial reporting of the corporate chief’s breaking revelation. One well-known legislator even rebuked me later for suggesting that Stallone had made a “slip of the tongue.”
But now it seems clear. Stallone held in the back of his mind something he thought premature to state publicly at the time.
Friday morning, April 28th, Cayuga Health Systems, in a joint statement with Tompkins County Whole Health, announced the planned closure of its COVID-19 sampling site at the Shops at Ithaca Mall. The statement also confirmed that with the end of County Government subsidies in December of last year—yet with the hospital still having underwritten testing costs since then, but not beyond next month— some people now tested for COVID-19 may soon need to pay out of pocket for the service they receive.
The mall-based sampling site will close May 5th, Friday’s statement indicated.
The closure decision was made “following a multi-month review of notable decline of its use,” the joint statement explained. After the mall site closes, it continued, “Cayuga Health will offer testing to the public at physician offices, including walk-in visits at Immediate Care (its outpatient clinic in northeast Ithaca), and at other healthcare providers in the community.”
The mall-based sampling site opened in September 2020, some six months after the COVID-19 pandemic began. It opened in large part because of encouragement from key Tompkins County lawmakers, including then-legislator (and now New York State Assemblymember) Anna Kelles and current Legislature Chair Shawna Black. Enfield Councilperson Robert Lynch (this writer) spoke before the County Legislature August 18, 2020 in support of County Government subsidies credited with making local sampling free. An initial County infusion of $300,000 got the project going. More similarly-sized appropriations followed.
But the Tompkins County Legislature quietly let the subsidies lapse with the end of last year. And since then, public officials have offered little clarity about whether or how those seeking discretionary testing—a test without explicit medical necessity—would be charged for the service.
Friday’s announcement finally clarified how those charges would be handled, advice consistent with an initial response that Tompkins County Whole Health Commissioner Frank Kruppa had provided this Councilperson during an intermunicipal zoom conference April 6th:
“Residents seeking a test through Cayuga Health and other local healthcare providers must meet criteria as medically necessary for health insurance coverage or pay out of pocket for the service,” Friday’s news release stated. “Medically necessary testing includes having symptoms related to COVID-19, exposure to someone with COVID-19, or having an upcoming medical procedure,” the news release continued.
The statement stressed the reliability of self-testing and that test kits are readily available free of charge (including at the Enfield Town Clerk’s Office).
“This is one of the best investments Tompkins County made during the pandemic,” Tompkins County Legislature Chair Shawna Black said. “I’m so proud that our Legislature stepped up to approve this funding and has been responsive to the community’s needs throughout this crisis.”
Black’s statement made no reference to any effort by her or any other public official to renew governmental support for the testing service, one that had allowed any Tompkins County resident without third-party reimbursement to receive the COVID testing at the mall free of charge.
And soon, even the insured may need to pay out-of-pocket. A Federal Emergency Declaration is set to expire May 11th. And when it does, Health Department officials warn, the expiration will mean “ending the availability of federal funds for free testing services or supplies, and vaccines available free of cost.” That could mean health insurance co-pays, depending on one’s insurance carrier, those officials say.
“It is best to speak with your insurance provider to find out what the cost of a receiving a PCR test would be, or the cost of the vaccine, as different insurances offer different options,” Friday’s statement advised.
Until this latest announcement, it remained unclear whether those currently being tested at the mall sampling site would be charged for their tests now with local governmental subsidies having ended.
“Cayuga Health covered costs from January 2023 through May 2023,” the Friday statement revealed. It explained that its short-term hospital-paid subsidy, “allowed the Tompkins County community to access testing without barriers or concern about payment.”
Sadly, however, community leaders remained virtually silent over the period and never publicly discussed their appraisal of the program during the first four months of 2023 or whether taxpayer subsidies should renew.
“This is an end of an era; a troubling time, yet one that arose from medical necessity,” Enfield Councilperson Lynch remarked following Friday’s confirmation of the sampling site’s impending closure and the clarification of payment requirements.
“We tapped our county’s massive fund balance once to underwrite this service,” Lynch said. “We should renew the conversation about tapping it again. Our fund balance grew during the pandemic. It grows today. As my own legislator, Randy Brown, has said, this isn’t the County’s money; ‘this is the people’s money.’ Perhaps the people would like to spend a little of it to continue free testing.”
Nonetheless, continuing the program poses a problem. It’s a financial one. Though the federal government was initially slow to reimburse Tompkins County for its testing costs, Washington eventually did come through with payment. But with next month’s expiration of a national Emergency Declaration, renewed federal subsidies stand unlikely.
All of those quoted in Friday’s announcement of the mall site’s closure sounded resolved to both the sampling site’s shuttering and the ending of the funding partnership that has provided free COVID testing for nearly three years.
“I want to thank Cayuga Health for setting up and managing the mass sampling site since early in the pandemic,” Commissioner Kruppa said. “This has been a great service to our community and contributed to our monitoring of disease in the community.”
Kruppa added, “Although this service is coming to an end, I want to remind the community that it is still important to get tested and take precautions when sick.”
Dr. Stallone agreed that it was a time to move on, while also celebrating a job he believed was well done. “It was an honor to provide this vital service to our community during a time of great uncertainty,” Cayuga Health’s CEO said. “Cayuga Health appreciates the trust the Health Department and Legislature placed in us.”