November 26, 2024

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How a Lack of Federal COVID Funds Could Impact Health Care

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For the most up-to-date news and information about the coronavirus pandemic, visit the WHO and CDC websites.

US President Joe Biden on Wednesday amped up the call to Congress to provide more pandemic funds, telling lawmakers that if they don’t act, “We won’t have the supply we need this fall to ensure that shots are available, free, easily accessible for all Americans.”

Now lawmakers might be closer to passing a COVID-19 funding deal, according to a Washington Post report, though it’s a smaller budget than what the administration initially asked for. Republicans initially pushed back against a pandemic relief package, leading to bipartisan efforts to find a new plan. After failing to agree on a pandemic aid package, lawmakers stripped it from a larger spending bill altogether.

Biden said there’s enough supply in the US to provide the shots promised to people who are newly eligible for a second COVID-19 booster, but the White House has warned about the consequences of Congress failing to agree on a budget that included funds for pandemic preparedness. The availability of free COVID-19 tests, free vaccines regardless of insurance status, and treatments for people most at risk of severe disease are all on the line, officials say. 

Monoclonal antibody treatments will run out as soon as May, and without additional funds the government won’t be able to order any more doses of Paxlovid, a highly effective COVID-19 treatment against omicron. The US Department of Health and Human Services already announced that its program for uninsured Americans has expired, which means providers are no longer able to submit claims for patients without coverage through private insurance, Medicare or Medicaid.

By April 5, the uninsured program will also stop accepting claims for COVID-19 vaccines, despite the country’s promise that everyone — regardless of insurance or immigration status — can get a free COVID-19 vaccine or booster shot without worrying about hidden costs. 

“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, professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, said last week 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 $10 to spend on an extra test,” she said. 

Despite the country’s broad loosening of COVID-19 public restrictions, the pandemic isn’t over. Experts are currently watching a new type of “stealth omicron” (BA.2), which doesn’t appear to cause more disease severity than the original. But given its bump in contagiousness, it’s causing a small increase in cases in some areas, including New York City. Fortunately, US COVID-19 hospitalization rates and deaths continue to decrease, as do COVID-19 average weekly deaths worldwide.

Without action from Congress, members of the Biden administration and health care providers alike are warning about the potential consequences for health care.

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If I need a fourth shot or extra booster, will it still be free?

This week, the CDC signed off on second COVID-19 boosters for adults over age 50, immunocompromised people and people who’ve received Johnson & Johnson’s vaccine plus booster dose. 

At a recent media briefing with the White House COVID-19 Response Team, coordinator Jeff Zients said there’s enough government supply of vaccines to get eligible immunocompromised people a fourth shot, and also enough to secure fourth doses for other vulnerable populations, including seniors.

The bigger booster funding concern is for the general population, for which health regulators could authorize or recommend extra doses in the near future. 

Should health agencies call for fourth doses for all adults, or even “if things change and there’s a need for a new vaccine,” Zients said, the US government won’t be able to fulfill the need without additional funds.

The FDA’s independent advisory committee is meeting April 6 to discuss the need for future COVID-19 boosters in the general population, as well as the potential need for a future vaccine.

Can I still get a COVID vaccine or booster if I don’t have health insurance?

The Uninsured Americans program will stop accepting claims on April 5 from health care providers for people without health insurance when they go in to get a shot. That means that people without health insurance starting in April could potentially be charged an administration fee for the vaccine, but the dose itself will still be free, because there are still vaccines in stock that’ve been purchased by the government. 

How exactly it will unfold without more funding remains unclear, and may also depend on your state’s resources or community programs.

Should Congress not provide more funding, there are programs that have helped adults and children without health insurance secure other vaccines, according to the Kaiser Family Foundation: the Vaccines for Children Program (VCP) and the Section 317 Vaccine Program. The 317 program, however, also relies on additional funding, per the KFF.

Though the CDC’s advisory committee will need to recommend the COVID-19 vaccines as part of the program (but should federal funds run out, we may expect them to) providers giving the shots could charge an administration fee but aren’t allowed to turn away patients that can’t pay, according to the KFF. 

If you need a first shot, a second dose or have been waiting to get your booster, you can still find a vaccine site and see which shots are available near you by texting your ZIP code to 438829 or by visiting vaccines.gov.

Will we still get free vaccines for children?

Zients also said that when a COVID-19 vaccine is available to children under age 5, the US will have the supply needed to vaccinate that age group. Moderna and Pfizer are both pursuing a vaccine for the youngest and last age group to be vaccinated, but neither has received FDA authorization yet.

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What about COVID tests and treatments if I don’t have insurance? 

The same government program for Americans without health insurance, citing “lack of sufficient funds,” stopped accepting claims for COVID-19 tests and treatments on March 22. This means health care providers will either be forced to “absorb the cost or turn away people who are uninsured,” the White House said.

If you don’t have health insurance and need a COVID-19 test or treatment right now, call wherever you’d go for the test or treatment to see how, or if, it’ll affect you. If you haven’t already, you can order a second round of COVID-19 tests paid for by the government by visiting the US Postal Service website.

Quest Diagnostics, a large testing provider, may now charge up to $125 for a PCR test without insurance, ABC News reported. Prices from testing services may vary, and ABC reported that companies such as Walgreens are waiting on more guidance from the White House.

What else will happen if funds run dry? 

In addition to affecting future supplies of monoclonal antibodies and pill treatments for COVID-19, the supply of AstraZeneca’s prevention drug for immunocompromised people may also dwindle, HHS Secretary Xavier Becerra said at a White House COVID-19 briefing. The White House says it also needs more money to fund research on pan-coronavirus vaccines, which have the potential to be more effective at targeting future variants.

Other countries may also be impacted by a lack of US COVID-19 funding, as some of the money for the pandemic response goes to vaccination aid abroad. Only 14.5% of people in low-income countries have received at least one dose of a COVID-19 vaccine, according to Our World in Data. 

Dr. Anna Durbin, a professor in the Department of International Health at Johns Hopkins Bloomberg School of Public Health, suggested at a media briefing this week that the concern in lack of funding extends beyond the current COVID-19 wave, and into future pandemics of different viruses. Will we be prepared? 

“We’ve had previous examples where we were concerned about pandemics — whether it be from another H1N1, another avian influenza virus, SARS-CoV-1,” she said. “And we realize we didn’t put the money into prevention that we could’ve at the time.” 

When COVID-19 came around, the US was not prepared, she said. 

“Now is the time to really cement that funding and think about the future and prevention,” Durbin said. “Not just of COVID, but of future pandemics that are surely going to come.” 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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