Get ready to start paying for your own Covid-19 tests and treatments

Get ready to start paying for your own Covid-19 tests and treatments

Federal funding for Covid-19 response measures like tests, treatments, and vaccines is drying up just as cases are poised to rise again, raising another barrier for some of the most vulnerable Americans.

Several key factors are different in this go-around, however: The vast majority of people in the US have already been infected or vaccinated, so most have at least some protection from the disease. Many effective treatments are available, such as the Paxlovid antiviral drug, which can help even those who get sick. However, most of the public health precautions to prevent infections such as wearing masks or social distancing have been abandoned. Tracking the pandemic is getting harder too, with most Covid-19 tests now occurring at home and going unreported. The Centers for Disease Control and Prevention declared last month that it would shift from daily reports to weekly ones of deaths and cases. Currently, more than 2,600 people in the US are dying per week from Covid-19.

Now the government is turning over some of the Covid-19 response to the private sector. Throughout the pandemic, the federal government spent billions of dollars on these measures and provided them for free to the public under its public health emergency powers. The emergency declaration has to be renewed every 90 days, and the current round expires in 2023. Americans may have to pay out-of-pocket if the government does not renew the emergency declaration by the deadline.

This funding rollback will likely play out differently depending on the measure. Manufacturers are raising prices for vaccines. Pfizer announced last month that it’s planning to raise the price of its Covid-19 vaccine next year, from the roughly $30 per dose it charges the US government now to at least $110 per dose.

However, the US government has a stockpile of Covid-19 vaccines, including new bivalent boosters that target more recent variants of the virus that causes Covid-19. With booster rates still in the single digits, the US isn’t running out of Covid-19 vaccines anytime soon. When prices do go up, health insurers will be required to offer them to their customers for free under most plans.

“Almost everybody will still be getting free vaccines,” said Jennifer Kates, senior vice president at the Kaiser Family Foundation, a health policy think tank. “The only group that’s out of luck there are uninsured adults.”

Tests are a different story. The government’s free at-home test program ended in September because Congress didn’t appropriate more money to order more kits. Insurers are still require to reimburse part or all of the cost of home Covid-19 test kits as well as more robust PCR tests, but when the public health emergency ends, policyholders will likely end up paying more out of pocket. People without insurance are likely to pay the highest.

Americans may also end up paying more for Covid-19 treatments like antiviral drugs and monoclonal antibodies. These therapies have been crucial in reducing the death rate from the disease, and the government has them stockpiled. But as the emergency ends and supplies run out, people on private health plans and on Medicare will likely have to share more of the costs.

What effect will funding cuts have on the economy? Is it premature to make these funding cuts?

“The data doesn’t tell me that it’s time for us to pull back, but it’s kind of where we are,” said Thomas LaVeist, dean of the school of public health at Tulane University.

On one hand, Covid-19 cases, hospitalizations, and deaths are far below their peak, many people have largely checked out from taking precautions, and there are still supplies left. The people who are at greatest risk of severe illness and death from Covid-19 even now are those who are unvaccinated, but the overall vaccination rate is unlikely to budge now.

“At this point, it’s not clear to me that we’re going to get many more people vaccinated who are unvaccinated,” said LaVeist.

At the same time, Covid-19 cases are projected to rise again this winter, along with other infections like RSV and influenza, again stressing the health care system. Cost increases will cause already low rates of vaccine testing and treatment, putting more stress on already stressed hospitals and health care workers.

Eventually, funding for some of these pandemic measures does have to taper off, but the looming rollbacks are more abrupt than some policymakers wanted. “Waiting to provide funding once we’re in a surge will be too late,” according to a March 15 statement from the White House warning Congress about the dangers of a sudden loss of Covid-19 funding. Kates stated that the hope was for a seamless, well-balanced transition and not a steep slope.

But with an upcoming election and Republicans poised to gain seats in the House, it will likely be harder to get any more money for tests, treatments, and vaccines. “There is a political aspect to this as well: Because people are fatigued, policymakers don’t want to continue these measures because they’re being pressured not to,” LaVeist said.

Nonetheless, the worst effects of Covid-19 can still be contained. Improved ventilation and face masks are two ways to reduce the risk of infection. Vaccine boosters may also be helpful. Treatments that can save lives can help. Preventing another spike in deaths is a matter of availing these tools, especially while they’re still free.

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