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Government no longer paying cost of COVID tests, treatment, leave

The Biden administration said it’s out of money to fund costs for tests, vaccine, treatment and sick time

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Youngstown City Health Department worker Faith Terreri grabs two at-home COVID-19 test kits to be handed out during a distribution event, Dec. 30, 2021, in Youngstown, Ohio. The Biden administration recently said it’s out of money to fund costs for tests, vaccine, treatment and sick time related to COVID-19.

David Dermer, Associated Press

If you’ve managed to avoid COVID-19 so far, you may not be as lucky as you think — should you get the virus in the future.

The government is handing the cost of COVID-19, from testing to treatment and time off work, back to those who would cover such costs of other illnesses: that means insurance, if you have it, complete with out-of-pocket costs. And you’ll most likely have to use your sick leave or vacation time to be off work, if you actually have vacation and sick leave.

Advisory.com reports that “as federal funding for COVID-19 vaccines and treatments dwindles and cases decline, the Biden administration is planning to stop paying for these products and transition to a more standard purchasing process through different health care system channels, including commercial insurers and pharmacy benefit managers.

The Biden administration no longer provides monoclonal antibody treatment for COVID-19. As the Deseret News recently reported, it has stopped providing free tests, though it is stockpiling in case there’s a surge this fall. Vaccines will also be the responsibility of insurers or consumers, raising some concern that people will skip getting vaccinated.

The exception is the omicron BA.5 vaccine — they will continue for the foreseeable future to be available to everyone for whom they are approved.

The administration said the issue is funding. It asked for $22.5 billion to cover some pandemic costs, but Congress didn’t fund the request.

“As the pandemic moves past the crisis phase, the Biden administration says it’s transitioning those Covid-19-related costs to public and private markets, including health insurers and pharmacies,” Forbes reported. “White House Covid-19 Response Team coordinator Dr. Ashish Jha said his ‘hope is that in 2023, you’re going to see the commercialization of almost all of these products.’”

The article said both Medicare and Medicaid programs would protect access through the end of the year and vaccines into the future. Some tests or treatments may be subject to copays, as well as prior authorization.

Eli Lilly in August said it would begin selling its monoclonal antibody bebtelovimab commercially. Prior sales had been to the government, which provided free access as the antibodies were needed.

Stephanie Armour, a Wall Street Journal reporter, told NPR’s Steve Inskeep that the uninsured are likely to be the hardest-hit because how they’ll have access is a big question. “We’ve got roughly 30 million people in the United States that don’t have health coverage,” she said.

She noted the Biden administration and drugmakers are going to discuss “what kind of systems can be set up to try to maintain some kind of access and equity, especially when you look at vaccines and the importance of maintaining boosters that people will need to keep having at this point. So that’s one of the big question marks that’s out there.”

She also noted that because antivirals for COVID-19 have been approved under an emergency use authorization by the U.S. Food and Drug Administration, rather than receiving full approval, that could limit or end access for those who have Medicare or Medicaid, because they don’t cover drugs under emergency use authorization.

Some states are providing some relief on their own — at least in the short term. Depending on whether California Gov. Gavin Newsom signs the bill, the California Assembly opted to extend its supplemental paid sick leave through the end of the year and give small businesses some relief for sick leave costs, according to The National Law Review. The California Labor and Employment Law blog was among those predicting Newsom would sign the measure.