Uninsured May Lose Access to COVID-19 Services Without Federal Funds

Uninsured individuals may lose access to free COVID-19 testing, treatment, and vaccines when federal funds and supplies are exhausted, according to an issue brief from the Kaiser Family Foundation (KFF).

After requests from the White House for additional funding to support COVID-19 efforts, leaders reduced the initial amount of $22.5 billion to $15.6 billion and then eliminated it from the final spending bill for fiscal year 2022.

The federal government has announced that, without additional funding, the Health Resources and Services Administration (HRSA) COVID-19 Uninsured Program will end. HRSA created the program to increase access to COVID-19 testing, treatment, and vaccines for uninsured individuals by reimbursing healthcare providers who administer these services.

The program has stopped accepting reimbursement claims for COVID-19 testing and treatment and intends to stop receiving claims for vaccine administration on April 5, 2022, as of this article’s publication date. Additionally, the federal government will not provide funds to purchase more COVID-19 tests, treatments, and vaccines after the current supplies are gone.

The lack of federal funding will likely inhibit individuals from accessing these critical healthcare services as the pandemic continues. Uninsured individuals, in particular, may face significant repercussions, the KFF brief suggested.

The federal funds helped support the HRSA COVID-19 Uninsured Program and provided around $19 billion in reimbursement for testing, treatment, and vaccine claims for the uninsured. The funding has also covered the costs of COVID-19 tests, treatments, and vaccines, ensuring all individuals, regardless of insurance status, have access to the services for free.

All individuals can access the current supply of resources for free, as the federal government will continue distributing the remaining resources to states and health centers.

However, due to the discontinuation of the HRSA COVID-19 Uninsured Program, providers will no longer receive reimbursement for administering services to uninsured individuals even while the current supplies remain.

Fifteen states have implemented temporary Medicaid coverage to cover the cost of testing, treatment, and vaccines for uninsured individuals—a policy that expires after the public health emergency (PHE) ends. Uninsured people in states that have not leveraged this option may face barriers to COVID-19-related services.

Providers still must administer vaccines for free, but KFF researchers noted that some providers might start billing patients for other services or stop offering these services altogether.

Additionally, when the current supply of tests and treatments runs out, uninsured individuals may have to pay out of pocket for these services, the report stated. The uninsured population may choose to seek care from safety-net providers, but this would require the providers to absorb the costs without receiving reimbursement.

A handful of uninsured children and adults may still be able to receive the COVID-19 vaccine through immunization programs when federal funding runs out.

The Vaccines for Children program (VFC) provides children with access to vaccines that the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) recommend. Providers administering vaccines through this program can charge an administration fee but must still allow patients to receive the vaccine even if they cannot pay.

The Section 317 Vaccine program similarly provides approved vaccines to uninsured adults. Still, without additional funding, there will likely be only a limited number of vaccines available, and the programs will not be able to absorb the costs fully. The CDC has yet to determine if they will include the COVID-19 vaccine in these programs.

The lack of federal funding for COVID-19 services may also exacerbate racial care disparities and health inequities, as people of color are more likely to be uninsured than White individuals, the brief noted.

Individuals with public and private health insurance coverage will generally maintain access to no-cost COVID-19 services after the federal funding and supplies are exhausted. However, some provisions will end with the PHE.

Medicare and Medicaid beneficiaries will have access to tests and vaccines with no cost-sharing. Medicaid will provide no cost-sharing for treatments for at least a year after the PHE, but Medicare beneficiaries may have to pay out of pocket for treatment following the PHE.

Privately insured individuals can access tests, treatments, and vaccines with no cost-sharing during the PHE, but this policy will end for testing when the PHE expires. Additionally, if treatment and vaccine costs are shifted to payers, individuals may face higher premiums, the brief stated.