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Abstract

The COVID-19 pandemic laid bare the shared vulnerability inherent in the human condition, prompting a collective recognition of our physical susceptibility to infectious diseases. While great strides have been made in combating COVID-19 through vaccinations and treatments, a portion of the population remains profoundly vulnerable due to health conditions that make the disease more dangerous, that limit vaccine efficacy, or that prevent vaccination altogether.

This article explores a path forward by proposing a solution within health benefit plans—encompassing both private health insurance and public health benefits. Specifically, the article advocates for a coverage mandate for over-the-counter personal protective equipment (PPE) at zero out-of-pocket cost for vulnerable individuals. Drawing on the experiences of those facing heightened susceptibility, such as immunocompromised patients undergoing chemotherapy, the article highlights the critical role of PPE in safeguarding against infectious diseases.

The article proceeds with a comprehensive exploration, beginning with a background on infectious diseases and the context of COVID-19. It then scrutinizes the current landscape of health benefit plans and their coverage of personal protective equipment. The proposal is systematically presented, detailing how a mandate can be structured to implement comprehensive coverage and including an exploration of different design elements that could be utilized to broaden or narrow the coverage mandate.

The article advocates for a paradigm shift in health benefit plans to address the ongoing vulnerability faced by a segment of the population. By mandating zero out-of-pocket costs for PPE, this proposal aims to empower vulnerable individuals to protect themselves against infectious diseases. In doing so, it seeks to bridge the gap in current health coverage and foster a more inclusive and resilient healthcare system in the post-pandemic era.

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