With enactment of the Families First Coronavirus Response Act on March 18, 2020, the federal government took action to ensure access to COVID-19 testing. The legislation requires Medicare, Medicaid, all group health plans, and individual health insurance policies to cover testing and associated visits related to the diagnosis of COVID-19 with no cost sharing and prohibits plans from imposing prior authorization requirements on these services during the federally-declared emergency period. In addition, the new law gives states the option to provide Medicaid coverage of COVID-19 testing for uninsured residents with 100% federal financing.

Many states have also implemented policies to increase access to COVID-19 testing and treatment, as well as continued management of other health conditions. Some states have already indicated that they are requiring insurers to cover a COVID-19 vaccination with no cost-sharing if and when one becomes available, while others are requiring state-certified insurance carriers to waive patient cost-sharing for COVID-19 treatment, as well as treatment for other related conditions, including pneumonia and the flu. States have also announced other actions, including extending special enrollment periods in state-based health insurance marketplaces, facilitating early prescription drug refills, and relaxing prior authorization and utilization review processes. A number of states have responded to the pandemic by expanding access to telehealth services as well, with detailed actions captured in the telehealth-specific table below. In addition, states are requesting approval for Section 1135 waivers that permit them to waive or modify certain Medicare, Medicaid, CHIP, and HIPAA requirements during a national emergency.

Finally, while the new federal law creates a federal emergency paid sick leave program through December 2020, a number of states have enacted mandatory sick leave policies that will fill in gaps in the new federal emergency leave, while others are proposing to adopt these policies in the wake of the coronavirus outbreak.

With regard to the actions included in this resource, the map and table include only mandates (not recommendations or guidance) ordered by a state’s executive branch (not state legislature). The authority of governors to issue such mandates may vary by state. The actions pertain only to state-regulated private plans and do not include self-insured employer plans or public plans such as Medicare and Medicaid.