Health and Human Services Secretary Xavier Becerra tests before the Senate Health, Education, Labor, and Pensions Committee hearing to discuss reopening schools during the coronavirus disease (COVID-19) on Capitol Hill in Washington, DC, September 30, 2021.
Shawn Theo | pool | Reuters
People who don’t have health insurance are charged $100 or more for a Covid test by some labs, may face hospital bills, and it may not be easy for everyone to get free vaccines since federal emergency aid for some pandemic programs is out of stock and hasn’t been renewed. Congress.
Senators reached a $10 billion Covid financing deal last week. However, the package does not include the White House’s $1.5 billion request for a program that covers testing and treatment for the uninsured as well as some vaccine costs managed by the Department of Health and Human Services, according to deal summaries released by the offices of Senate Majority Leader Chuck Schumer, DNY, and the senator. Mitt Romney, Utah.
A top House Democrat aide told CNBC that Senate and House negotiators have dropped funding for the uninsured after Republicans opposed funds needed to extend the program. The emails to House and Senate Republican leaders were not immediately returned.
The current Senate package will fund additional supplies of vaccines, monoclonal antibody therapies, and antiviral pills, as well as research into the next generation of injections. Congress left Washington last Thursday for a two-week recess without the deal passed, so it’s not clear when a vote could be held. Republicans blocked the bill from advancing on the Biden administration’s decision to end a CDC policy that deported immigrants crossing the U.S. land border as a pandemic emergency measure.
The $10 billion Senate deal is less than half the $22.5 billion President Joe Biden originally requested, and each chamber still had to be cleared before it was sent to Biden for his approval. It’s not clear how the deal would work in the House if the Senate succeeded in passing it, or if there would be any flexibility in transferring some of the $10 billion to help the uninsured.
Meanwhile, the Department of Health Resources and Services, which operates the uninsured program for HHS, stopped accepting claims to test and treat uninsured Covid patients on March 22 due to insufficient funds. While the US offers Covid shots for free, the agency stopped covering administrative costs for administering vaccines to uninsured people starting April 5, shortly after the Food and Drug Administration gave second booster shots to people over 50.
“All those doctors, hospitals, pharmacists, nursing homes, community health centers who were relying on the Congressional Relief Fund to help reimburse them for some of the costs related to Covid — those costs are now off,” Secretary of Health and Human Services Xavier Becerra said last week. “Claims are no longer accepted as of this week until vaccines.”
Many of the major testing companies are now charging the uninsured. Quest Diagnostics told CNBC that uninsured people now have to pay at least $100 for a PCR test, the most accurate test.. Labcorp told CNBC that the company charges $119 for an at-home or in-person PCR test for people who aren’t covered by insurance.. Curative, which operates thousands of testing sites in 34 states, said it can no longer provide free Covid testing to the uninsured in areas of the country where state or local governments do not pick up the tab. The company said it is trialling a program where the uninsured can pay $99 to $135 in cash to take the tests, depending on the type of product in specific locations.
“We are very concerned about this latest development in terms of federal funding and the impact it will have on uninsured patients. We are asking for re-funding to ensure that uninsured patients have access to out-of-pocket tests,” a spokesperson said.
The two companies told CNBC that CVS and Walgreens are still providing tests, antiviral tablets and vaccines to the uninsured for free. CVS spokesman Mike DeAngeles said the company is confident that the White House and Congress will find a solution that will give the uninsured free access to Covid services. Walgreens spokeswoman Alex Brown said the company is awaiting further guidance from the White House once the Covid funding deal has already passed.
Without additional federal funds, people in the United States will face significantly reduced access to testing, especially the uninsured, which will likely lead to a potentially preventable outbreak of Covid, according to Dr. George Benjamin, executive director of the American Public Health Association.
“You’re going to have people like we did in the first part of the pandemic who have to look for tests,” Benjamin said. “It’s a disaster waiting to happen, and it’s prolonging this outbreak for longer than it should.”
Uninsured people hospitalized with Covid may face their treatment bills now that the federal government has stopped paying for hospitals, according to Molly Smith of the American Hospital Association. Smith said treating someone with Covid could cost anywhere from tens of thousands to hundreds of thousands of dollars if the patient ended up on a ventilator.
Smith said some hospitals have financial assistance plans for the uninsured. However, there is a growing concern that some patients simply will not go to hospital when they need treatment for Covid because they are concerned about the cost of doing so now.
“We know that people’s fear of the cost of care is a huge barrier that really exists,” said Smith, the AHA’s vice president for policy. “Our biggest fear is people avoiding care at all.”
Uninsured people may also have difficulty getting vaccinations. Health care providers sign agreements with the Centers for Disease Control and Prevention in which they are required to provide vaccines to patients for free regardless of their insurance status. The federal government was covering the costs of the shots as well as the administrative expenses incurred by companies such as CVS and Walgreens that operate the shots. Without $1.5 billion, companies would be in trouble to cover these additional fees on their own.
The CDC told pharmacies that they still must provide the injections at no cost if they participate in the federal vaccination program. However, the agreements are voluntary, which means pharmacies can opt out of the program at any time, and the CDC can also fire providers who don’t follow the rules.
This means pharmacies can leave the federal vaccination program if they cannot afford the administrative costs. Pharmacies administer about 42% of Covid vaccines in the United States, according to data from the Centers for Disease Control and Prevention.
More than two dozen pharmacy associations, House Speaker Nancy Pelosi, D-Calif., and minority leader Kevin McCarthy, D-Calif., wrote late last month calling for Congress to take immediate action to fully fund the uninsured program. They warned that failure to fund the program would jeopardize equitable access to vaccines for people without health insurance.
Smaller independent pharmacies now face a particularly difficult choice because they already operate at thin margins, according to Rona Hauser, vice president of policy at the National Community Pharmacists Syndicate.
“For the vast majority of our members who are providing out-of-compensation care at this point in the pandemic, it is a very difficult decision to make financially and unfortunately we will not be able to do so largely,” Hauser said.
There were 28 million uninsured people in the United States in 2020, according to the most recent data available from the Census Bureau. The current number of uninsured is likely lower because 14.2 million people were enrolled in health insurance through the Affordable Care Act as of January of this year, about 2 million more than the previous record of 12.6 million set in 2016.
Uninsured people are often people of color and low-income workers who have jobs that put them at greater risk of infection because they work in industries like retail, restaurants, and grocery stores where they interact with the public and can’t stay home, according to Jennifer Tolbert, an expert on the uninsured at The Kaiser Family Foundation.
While Covid cases are currently low in the United States compared to the Omicron winter wave peak, barriers to testing will make these communities more vulnerable again if another wave hits the United States, Tolbert said. Curative said its real-time data points to another potential surge on the horizon.
“If you think about this from a public health perspective, it’s just about being prepared in case there’s another surge so you’re not surprised before you can put all the pieces back in place to ensure people can get access to testing and treatment.”
The uninsured program, which was set up at the start of the pandemic under the Trump administration, has paid about $20 billion in claims since 2020, according to HRSA. About 60% of that money went to testing, 31% for Covid treatments, and 9% for the administrative costs of vaccinations, Tolbert said.
The HRSA said that people without health coverage should check their eligibility for Medicaid and available plans through the ACA at health.gov. Uninsured people can also request free home tests from the government at covidtest.gov, although families are restricted to two sets of four tests.
The uninsured can also continue to receive free Covid services at federally supported community health centers across the country, which can be found through the HHS website.
“The truth is that unfortunately the uninsured are the last people to think about and the first to get negative results when we decide to withdraw,” Benjamin said.