The COVID-19 pandemic is producing a deeply uncertain period for the economy, and one of the places that’s playing out in a big way is in health care — specifically, what consumers will end up paying for their care and health insurance down the road.

Covered California, the state health insurance marketplace, has a report out estimating COVID-19 testing and treatment will cost the commercial market between $34 billion and $251 billion. The report finds that insurance premiums in private plans could jump from 4% to 40%. That’s a pretty big range, and it has a lot to do with no one knowing how costs will be distributed across the health care landscape.

“Some of the costs of treating patients with coronavirus are just not being paid for at all,” said Ateev Mehrotra, who teaches health care policy at Harvard University.

But this much is certain: the bills will come. Some will get picked up by Medicare and Medicaid, and others by private insurers and individuals. And some costs will be eaten by clinics and hospitals, Mehrotra said.

But there may be mitigating factors that limit the financial impact of the pandemic, he added.

“Patients are understandably scared to go get health care, so a lot of other forms of healthcare have been reduced,” he said.

Discussions about coronavirus costs, and who pays them, are happening now, said Benjamin Isgur, who leads the Health Research Institute at PWC.

“If we’re thinking about the employer insurance market, this is the time period when health plan actuaries are starting to think about what next year’s costs will be,” he said. 

The problem is, those actuaries, when trying to figure out what employers and individuals will have to pay, have little data to work with.