Uninsured face surprise medical bills for Covid tests and hospital care after US Congress fails to fund pandemic relief package

Health and Human Services Secretary Xavier Becerra testifies before the Senate Committee on Health, Education, Labor and Pensions hearing to discuss reopening schools during the coronavirus disease (COVID-19) on Capitol Hill in Washington, DC on September 30, 2021.

Shawn Thew | Swimming pool | Reuters

People without health insurance are now being charged $100 or more for Covid tests by some labs and may face hospital treatment bills, and free vaccines may not be as easy to obtain for everyone since emergency federal aid for some pandemic programs ran out and was not renewed by Congress.

The senators reached a $10 billion bipartisan funding 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 uninsured people as well as some vaccine costs administered by the Department of Health and Human Resources. Human Services, according to summaries of the agreement released by the offices of Senate Majority Leader Chuck Schumer, DN.Y., and Sen. Mitt Romney, R-Utah.

Funding for the uninsured was scrapped by Senate and House negotiators after Republicans objected to the money needed to extend the program, a senior US House Democratic official told CNBC. . Emails to House and Senate GOP leaders were not immediately returned.

The current Senate package would fund additional supplies of vaccines, monoclonal antibody treatments, antiviral pills as well as research for the next generation of vaccines. Congress left Washington last Thursday for a two-week recess without passing the deal, so it’s unclear when a vote might take place. Republicans blocked the bill from advancing on the Biden administration’s decision to end a CDC policy that deported migrants crossing U.S. land borders as an emergency pandemic measure.

The Senate’s $10 billion deal is less than half of the $22.5 billion initially requested by President Joe Biden, and it still needs to clear every chamber before it can be sent to Biden for his approval. It’s unclear how the deal would fare in the House if the Senate were successful in passing it, or if there was some flexibility for some of the $10 billion to be moved to help the uninsured.

Meanwhile, the Health Resources and Services Administration, which runs the uninsured program for HHS, stopped accepting requests for testing and treatment from uninsured Covid patients on March 22 due to a lack of funds. While the US provides free Covid shots, the agency stopped covering vaccine administration costs for uninsured people starting April 5, shortly after the FDA cleared second shots. reminder for people aged 50 and over.

“All those doctors, hospitals, pharmacists, nursing homes, community health centers who were relying on the provider relief fund that Congress enacted to help them pay off some of the Covid-related costs — those have now been arrested,” Health and Human Services Secretary Xavier Becerra said last week. “Complaints are no longer accepted from this week, even for vaccines.”

Several major testing companies now charge for the uninsured. Quest Diagnostics told CNBC that uninsured people must now pay at least $100 for a PCR test, which is the most accurate.. Labcorp told CNBC the company charges $119 for its at-home or in-person PCR tests 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 tests to uninsured people in areas of the country where state or local governments are not footing the bill. The company said it is piloting a program where uninsured people can pay $99 to $135 in cash for tests, depending on the type of product on some sites.

“We are deeply concerned about this recent development regarding federal funding and the impact it will have on uninsured patients. We are calling for funding to be restored to ensure uninsured patients do not have access to any out-of-pocket testing,” a Curative spokesperson said.

CVS and Walgreens are still providing free tests, antiviral pills and vaccines to uninsured people, the companies told CNBC. CVS spokesman Mike DeAngelis said the company is confident the White House and Congress will find a solution that gives the uninsured free access to Covid services. Walgreens spokeswoman Alex Brown said the company awaits further guidance from the White House once a Covid funding deal is actually in place.

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Without additional federal money, people in the United States will face a dramatic reduction in access to testing, especially the uninsured, which will likely lead to preventable Covid outbreaks, according to Dr. Georges Benjamin, executive director of the American Public Health Association.

“You’re going to have people like we had in the early part of the pandemic who have to hunt to get tested,” Benjamin said. “It’s an impending disaster, and it’s only prolonging this outbreak longer than necessary.”

Uninsured people who are hospitalized with Covid could also face bills for their treatment now that the federal government is no longer reimbursing hospitals, according to Molly Smith of the American Hospital Association. Smith said treating someone with Covid can cost between tens of thousands and hundreds of thousands of dollars if the patient ends up on a mechanical ventilator.

Some hospitals have financial assistance plans for the uninsured, Smith said. However, there are growing concerns that some patients simply won’t go to hospital when they need treatment for Covid, as they worry about the current cost.

“We know that people’s fear about the cost of care is a significant barrier that already exists,” said Smith, AHA vice president for policy. “Our biggest fear is that people will simply avoid avoiding care.”

Uninsured people could also face reduced access to vaccines. Health care providers sign agreements with the Centers for Disease Control and Prevention in which they are required to offer free vaccines to patients, regardless of their insurance status. The federal government covered the costs of the injections as well as administrative expenses incurred by companies like CVS and Walgreens who administer the injections. Without the $1.5 billion, companies will have to cover these additional costs themselves.

The CDC has told pharmacies that they are still required to offer vaccines for free if they participate in the federal vaccination program. However, the agreements are voluntary, meaning pharmacies can opt out of the program at any time, and the CDC can also kick out providers who don’t follow the rules.

This means that pharmacies could leave the federal vaccination program if they are unable to meet the administrative costs. Pharmacies administered about 42% of Covid vaccinations in the United States, according to CDC data.

More than two dozen pharmacy associations wrote to House Speaker Nancy Pelosi, D-California, and Minority Leader Kevin McCarthy, R-California, late last month, calling on Congress to take action. immediate action to fully fund the uninsured program. They warned that the lack of funding for the program would compromise equitable access to vaccines for people who do not have health insurance.

Small independent pharmacies now face an especially tough choice because they already operate on extremely thin margins, according to Ronna Hauser, senior vice president of policy for the National Community Pharmacists Association.

“For the vast majority of our members, providing unpaid care at this stage of the pandemic is a very difficult decision to make financially and unfortunately we will not be able to do so to a great extent,” 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 people is likely lower due to a record 14.2 million people getting health insurance through the Affordable Care Act in January this year, or about 2 million people from more than the previous record of 12.6 million set in 2016.

The uninsured are often people of color and low-income workers who work in jobs that put them at higher risk of infection because they work in industries such as retail, restaurants and grocery stores. where they interact with the public and cannot stay at home. , according to Jennifer Tolbert, an uninsured specialist at the Kaiser Family Foundation.

While Covid cases are currently low in the United States compared to the peak of the winter omicron wave, barriers to testing will again make these communities more vulnerable 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 it from a public health perspective, it’s just a case of being prepared in case there’s a further outbreak so that you’re not caught off guard before you can put all the pieces back in place to ensure people can access the test. and treatment,” Tolbert said.

The uninsured program, established at the start of the pandemic under the Trump administration, has paid out about $20 billion in claims since 2020, according to HRSA. Tolbert said around 60% of that money was for testing, 31% for Covid treatments and 9% for administrative costs of vaccinations.

The HRSA said people without health coverage should check their eligibility for Medicaid and plans available through the ACA at healthcare.gov. Uninsured people can also order free home tests from the government at covidtest.gov, though households are limited to two sets of four tests.

Uninsured people can also continue to receive free Covid services at federally supported community health centers across the country, which can be located on the HHS website.

“The truth is, unfortunately, the uninsured are the last people think of and the first to get negative results when we decide to opt out,” Benjamin said.

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