The federal reimbursement program that let healthcare workers provide COVID-19 care for uninsured people is set to run out of cash Tuesday without signs of rescue as President Joe Biden and Congress find themselves at an impasse on funding.
The White House warned of the program’s ending in a recent plea for more funding to bolster the national pandemic response, which Republicans in Congress rejected when the $1.5 trillion government spending bill passed earlier this month.
“Providers will no longer be able to submit claims for providing these services to uninsured individuals, forcing providers to either absorb the cost or turn away people who are uninsured, increasing the disparity in access to critically needed health care and putting additional burdens on safety net providers,” the White House said last week.
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The COVID-19 Uninsured Program, which operates through the Health Resources and Services Administration, was established in 2020 as part of early pandemic-era legislation to make healthcare for COVID-19 accessible to people regardless of insurance and immigration status. The program has already paid out more than $18 billion to providers for testing, treating, or vaccinating uninsured people during the pandemic — $11.4 billion went to testing, $5.8 billion to treatment, and $1.6 billion to vaccinations. Uninsured people will have a bit longer to get vaccinated for free. HRSA will stop taking reimbursement claims for vaccinations at 11:59 pm on April 5.
Doctors who administered care through telehealth services, inpatient hospital stays, urgent care clinics, and other clinical settings could be reimbursed at Medicare rates, which are typically lower than those paid by private insurers. For example, healthcare professionals who administered a single dose of a COVID-19 vaccine could be reimbursed $40, while reimbursement for an antiviral such as Pfizer’s Paxlovid would be $12 per claim.
The program has been a lifeline for people in Texas, California, and Florida, which together filed more than 19,600 claims for treatments, tests, and vaccines totaling nearly $7 billion. The governors of Texas and Florida in particular have been strong proponents of monoclonal antibody treatments, a lifesaving tool for people who test positive and are at a high risk of being hospitalized with severe illness. Florida Gov. Ron DeSantis has clashed publicly with the Biden administration on multiple occasions over access to the antibodies, some of which were deemed ineffective against the omicron variant and pulled from the market.
Both sides remain deadlocked without a solution for healthcare providers in many large hospital systems that care for a high volume of uninsured patients. Harris Health System in Houston, for example, has already been repaid more than $196 million for treatments alone. A bill of that size could crush a smaller hospital system without the financial might of the federal government to prop it up.
“We support the Administration’s request for additional funding to ensure that the health care system has the resources it needs to continue to care for patients, especially as we continue to manage COVID-19 in communities across the nation,” said Molly Smith, group vice president of policy for the American Hospital Association.
The Biden administration had initially requested that Congress put $30 billion toward shoring up the national supply of vaccines, therapeutics, and tests. That figure was trimmed down to $22.5 billion, but Republicans in Congress shut down the request over transparency concerns. GOP lawmakers told the White House that they would have to see a detailed report on how funding allocated by Congress to deal with the pandemic had been spent before approving more. At the last minute, a more modest request for $15.6 billion in additional pandemic funding was yanked from the government spending bill, leaving the Biden administration scrambling.
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The winter omicron surge has largely abated, and federal health officials have declared it safe to remove masks in most public places, including schools, adopting an approach that embraces living with COVID-19 rather than eradicating it. Many Democratic-run states had followed federal guidance regarding masks and only recently lifted mandates, putting them more closely in line with Republican-led states that rejected such mandates before and during the omicron surge. But another spike in cases caused by an omicron offshoot could be brewing.
The BA.2 subvariant, the sister strain of the omicron BA.1 variant that has predominated globally, has gained traction in parts of Europe and the United Kingdom. The Biden administration is keeping an eye on omicron’s sister strain as it moves across the European continent. In the United States, BA.2 is already believed to account for slightly more than 23% of cases, up from about 13% earlier this month.
