COVID-19 vaccine providers can no longer be reimbursed for vaccinating the uninsured

The federal program that covered costs for vaccinating uninsured people against COVID-19 was set to end Wednesday, after the fund ran out of money amid a stalemate in Congress over federal COVID funding.

Vaccine providers across the Philadelphia region and the country will no longer be eligible to be reimbursed for vaccinations given to people without health insurance. Two weeks ago, the program stopped covering the cost of testing and treatments for uninsured people.

The federal program “has allowed uninsured Philadelphians to have the same level of access to potentially life-saving COVID-19 testing and vaccinations as the insured, which has likely led to higher testing rates and more people protecting those around them,” said Philadelphia health department spokesperson Matthew Rankin. “Not reinstating funding now could lead to disastrous results very soon.”

The loss of the program raises concerns about equity for uninsured Americans — an estimated 31 million people, according to the CDC — and has already resulted in higher costs and less access to testing for them. COVID vaccines remain free for all, but the providers who administer them can no longer collect reimbursements — which pharmacies, hospitals, and federally qualified health centers often rely on.

» READ MORE: Money for free COVID-19 testing for all runs out amid federal funding impasse

The uninsured program’s end comes just after the Senate on Monday announced a $10 billion COVID funding deal that, if passed, would provide money for vaccines, treatments, and supplies but falls short of President Joe Biden’s $22 billion ask for programs including global aid.

Public health experts are concerned that the lack of funding — including the loss of the uninsured program — could exacerbate barriers in low-income areas and communities of color, hamper states’ preparedness plans for the next phase of the pandemic, and cause problems as the BA.2 variant gains dominance in the United States.

» READ MORE: The BA.2 subvariant is now dominant in the U.S., and cases are already starting to inch back up in New Jersey

Though daily new case numbers have plateaued at a relatively low level after the record-setting omicron surge, some places are starting to see upticks, including New Jersey and Philadelphia, where health officials this week encouraged residents to wear masks indoors.

Continued access to testing is one of the key tools for preventing spread and identifying case increases, experts say. Some providers are now being forced to charge for COVID tests; others are eating the cost but aren’t sure how long they can do so.

All city-run clinics will continue offering free testing to all, but Philadelphia health officials are “extremely concerned” about residents being able to access testing, Rankin said.

Tests continue to be free for everyone at all CVS stores, spokesperson Matthew Blanchette said in a statement, adding that the company expected the federal government to find a solution that will guarantee uninsured people continued access to testing, vaccines, and treatment.

At Quest Diagnostics, though, the loss of reimbursement means the lab is now charging uninsured patients $100 for a doctor-referred PCR test, the list price, and $125 for one without a referral, said spokesperson Kimberly Gorode.

“We have begun to notify our clients and partners that we no longer expect to be reimbursed,” she said.

The uninsured program was set to accept claims for vaccinations until midnight on Tuesday, then stop processing any new claims. It underscored officials’ concerns about continued pandemic funding.

New Jersey Gov. Phil Murphy, as vice chair of the National Governors Association, has asked Congress and the Biden administration to ensure funding for states’ continued pandemic response.

» READ MORE: Millions still haven’t gotten COVID shots. What does that mean for the future of the vaccination effort?

“Federal funding has enabled us to obtain and employ critical resources — from testing to vaccines — in our fight against COVID-19,” said Christi Peace, spokesperson for Murphy. “The governor is encouraged by recent progress in Washington and urges the expeditious approval of federal COVID funding for states.”

It’s too early to gauge what kind of impact the loss of funding could have in New Jersey, said Department of Health spokesperson Donna Leusner, but the department “is monitoring for changes to our provider networks — especially in our most vulnerable communities.”

Federal funding for the uninsured program and other COVID-19 needs, including booster shots, treatments, and maintaining the public health infrastructure, is essential, said Rankin, the Philadelphia spokesperson.

“The health department wants to make it clear to Washington that the pandemic is not over,” he said. “Our public health systems need to continue to be robust.”