- Without additional funding from Congress, the Biden administration will be unable to pay for COVID-19 testing, treatment, and vaccines.
- One major issue is that the government will be unable to buy more vaccines for COVID-19.
- Another is that people may have to pay out of pocket for testing.
Last week, the Biden administration said unless Congress allocates additional funding, the administration has no more money to pay for COVID-19 testing, treatment, and vaccines.
Democrats stripped $15.6 billion in COVID-relief funding from a government bill earlier this month after they were unable to reach an agreement with Republicans on how to offset this new spending.
Lawmakers on both sides of the aisle continue to work on finding a COVID-19 funding proposal that will satisfy both parties. But as of now, there’s no sign that this will happen any time soon.
This funding shortfall will impact all Americans, but some groups will be affected more than others.
White House COVID-19 response coordinator Jeff Zients said in a Mar. 23 press briefing that the administration has enough vaccine supply to give a fourth dose to the most vulnerable Americans, including older adults and immunocompromised people.
But without more funding, the administration can’t purchase booster doses for other Americans, should one be needed later this year.
Likewise, if a variant-specific vaccine becomes necessary, the administration would need additional funding from Congress to buy enough doses — which could mean three doses each — for all Americans.
The existing supply of COVID-19 doses remains free to all Americans.
But the federal government was paying doctors, nurses, pharmacists, labs, and other healthcare providers to vaccinate people. This funding is set to end on Apr. 5.
After that, doctors’ offices, pharmacies, and other clinics may choose to absorb the cost of administering the vaccines. Or they may try to bill the cost to a person’s health insurance plan.
People with insurance may pay nothing, a small copayment or the full cost of administering the vaccine, depending on their plan.
The hardest hit will be uninsured people. Clinics set up to vaccinate Americans without insurance relied on federal funding to cover their costs. This includes outreach clinics to underserved communities.
Going forward, if Congress doesn’t allocate funding for additional vaccine doses beyond the existing supply, the COVID-19 vaccines would be available the same way most prescription medications.
Health insurers might cover all or part of the cost. People would pay different amounts, depending on their insurance.
Uninsured people would have to pay full price unless they could get vaccinated for free at a community health clinic.
Moderna CEO Stéphane Bancel said last week in an interview with Yahoo Finance that the company is “getting ready for a private market situation” such as this.
In this case, vaccine manufacturers would charge for the vaccines, which would be available through pharmacies, doctors’ offices, and other clinics.
However, with COVID-19 vaccines available for free, almost 20 percent of Americans eligible have not received even a single dose, according to CDC data.
Charging for the vaccines could deter more people from getting vaccinated or boosted.
“Studies over two decades have shown that if you make people pay more for something, they’ll buy less of it,” said Dr. A. Mark Fendrick, director of the University of Michigan’s Center for Value-Based Insurance Design (V-BID) in Ann Arbor, Michigan.
“And the people who are most substantially impacted are those with chronic medical conditions, people who are financially insecure, and black and brown communities,” he added.
Offsetting the costs of medical care such as vaccines can increase use, especially among more cost-conscious groups.
One of the studies that Fendrick coauthored showed that when you reduced out-of-pocket costs, financially vulnerable people increased their use of preventive care services.
Due to a lack of funding, the federal government has also had to cut back on its purchase of monoclonal antibody treatments and AstraZeneca’s Evusheld, said Xavier Becerra, Secretary of the Department of Health and Human Services, at the White House COVID-19 briefing last week.
Evusheld is an antibody combination drug that received
It is also approved for people who are allergic to or had a severe reaction to a COVID-19 vaccine.
Without additional government funding, existing supplies sent to states will dwindle.
In addition, Zients warned that unless Congress acts soon, the country’s testing manufacturing capacity will also decrease.
“Because it takes months to ramp back up — to rebuild capacity — failure to invest now will leave us with insufficient testing capacity and supply if we see another surge in cases and demand for testing increases once again,” he said.
Lack of testing capacity and treatment could directly impact Biden’s Test to Treat initiative, which allowed people to get a rapid test at a pharmacy or community health center and receive a COVID-19 treatment if they tested positive — both for free.
“While we’re still in the midst of Omicron and COVID and we’re not entirely back to normal yet … lack of funding to address that could really adversely affect our response to the pandemic,” Dr. Anna Durbin, a professor in the Johns Hopkins Bloomberg School of Public Health, said Mar. 24 at a COVID-19 media briefing.
As with vaccines, testing and treatments could also move toward a private market situation.
In this case, rapid tests would be sold at pharmacies or purchased by doctors’ offices and hospitals. People would either pay full price for these, or their health insurance could cover all or part of the cost.
Likewise, some COVID-19 treatments might still be available at pharmacies or doctors’ offices for full price or covered in part or fully by health insurance.
As with the vaccines, the uninsured and underinsured would be the hardest hit. If they couldn’t access treatments or tests for free at a community health center, they would either have to pay full price or forgo testing or care.
However, because the coronavirus is contagious, limiting access to vaccines, testing and care will impact not just the individual but also the wider community.
“We have the tools that work. And we know that if you have to pay to use those tools, it is a barrier,” Amber D’Souza, PhD, MPH, a professor at the Johns Hopkins Bloomberg School of Public Health, said Mar. 24 at a COVID-19 media briefing.
“When I walk into the grocery store and someone sneezes or coughs in the aisle next to me, I don’t want to worry that they didn’t have the ten dollars to spend on an extra test,” she added.