- Even now that the US public health emergency is over, uninsured Americans still have free access to the COVID-19 vaccine.
- Part of the reason is that the availability and cost of a coronavirus vaccine is determined by the federal government’s free vaccine supply, not by the declaration of a state of emergency.
- But even after the Biden administration’s stockpile runs out, the coronavirus vaccine will remain free for those without insurance.
- The Department of Health and Human Services and pharmaceutical companies Pfizer and Moderna have announced programs to fill that gap.
A healthcare worker prepares to receive a Pfizer BioNTech novel coronavirus vaccine at the Peabody Institute Library Vaccination Clinic in Peabody, Massachusetts, Wednesday, January 26, 2022.
Vanessa Leroy Bloomberg | Getty Images
Although the US public health emergency is over, uninsured Americans still have free access to the coronavirus vaccine for now.
of Biden administration A three-year state of emergency was lifted on Thursday, allowing the government to step up social safety net benefits and provide free coronavirus vaccines, tests and treatments during the pandemic.
but availability and cost Out of these vaccines is actually determined by the federal free vaccine supply, not by public health emergencies.
In other words, whether you have insurance or not, you won’t have to pay for a COVID-19 injection out of your own pocket as long as the stockpile lasts..
Providers of federally-purchased COVID-19 vaccines cannot charge patients or deny vaccinations based on a patient’s insurance status. According to the Centers for Disease Control and Prevention.
The Biden administration ordered a 171 million micron coronavirus booster last July.Since then, about 56 million Omicron injections were given, according to the CDC.
This will result in over 100 million shots being published for free. The government estimates that supplies could continue into the fall.
“There is still a lot of dose left. As you know, booster uptake isn’t very good,” said Jen Cates, senior vice president of the company. KFFMoreHealth Policy Research Institute.
But even after the federal stockpile runs out, most Americans won’t have to pay the out-of-pocket costs of buying a COVID-19 vaccine.
The government plans to shift distribution to the private market as soon as supplies of the new coronavirus vaccine run out.
That means vaccine makers Pfizer and Moderna will sell the vaccine directly to health care providers for about $130 per dose, almost five times the current price.
Insured Americans will now be able to get the COVID-19 vaccine at no out-of-pocket cost as part of their insurance.
Private insurers and government-run Medicare and Medicaid programs must cover all policies recommended by the CDC.
But for uninsured Americans, federal and corporate programs aim to fill that gap.
There are still questions about what these efforts will look like.
Here’s what we know about these programs so far:
CDC’s The “Vaccination for Children” program will provide free COVID-19 vaccinations to children who cannot afford to vaccinate their families or caregivers after the vaccine has been brought to the commercial market.
Children and youth under the age of 19 who are uninsured, underinsured, or eligible for Medicaid Permanent VFC program.
That program already offers free injections for other diseases, such as measles and chickenpox.
The CDC’s decision to include COVID-19 vaccination in its free vaccine program will be critical to maintaining access for many children, especially those who are excluded from other programs.
As many as 5 million children are expected to lose their health insurance through Medicaid and children’s health insurance programs if no public health emergency is declared. report From the Department of Health and Human Services last year.
The Biden administration has proposed creating a permanent program similar to the VFC for uninsured adults who can’t afford the COVID-19 vaccine or immunizations against other diseases. But Congress has so far failed to pass the proposal into law.
Meanwhile, the administration last month “HHS Bridge Access Program” It’s a temporary effort to provide free COVID-19 vaccinations and treatments to uninsured Americans once these products are brought to the commercial market.
Under this arrangement, CDC will continue to purchase and distribute COVID-19 vaccines at discounted prices through 64 state and local health departments.
The HHS effort will leverage a “public pledge” by pharmaceutical companies to provide free COVID-19 vaccines and treatments to the uninsured. As part of these efforts, HHS expects manufacturers to supply shots directly to pharmacies for free.
Cates said HHS appears to be referring to Pfizer and Moderna. Newly announced patient assistance programis committed to providing free Covid vaccines and treatments to uninsured people.
Cates told CNBC, “My understanding is that HHS basically pays pharmacies for administering vaccines and treatments to the general public, while manufacturers give pharmacies free vaccines as part of their patient assistance programs. We are planning to directly provide drugs and medicines,” he said.
Pfizer and Moderna have not said whether they will provide free injections to pharmacies.
Cates said the overall Bridge Access program would “definitely help” some uninsured Americans, but how many people will benefit and how long the program will be in place? It is still “difficult to determine” whether it will be, he added.
Pfizer and Moderna both plan to launch patient assistance programs for COVID-19 vaccinations, but the companies have provided few details about their efforts.
Patient assistance programs typically involve pharmacies and other vaccine providers paying companies up front for drugs, said Claire Hannan, executive director of the Institute of Immunization Administrators.
After administering the drug to an eligible patient, these providers can submit a reimbursement claim to the program for the cost of the drug, he said.
Pfizer’s Patient Assistance Program will allow eligible uninsured Americans to use the company’s novel coronavirus vaccine free of charge once the vaccine makes its way to the commercial market, a company spokesperson said. .Pfizer already support program Used instead of other drugs.
The company plans to share more information about the assistance program’s application process and eligibility guidelines as they become available, the spokesperson added.
Moderna said in February: patient support program It will go into effect after the public health emergency is over.
The company did not immediately respond to CNBC’s questions about the show’s details.
Lawmakers and health policy experts severely criticized Patient support programs that are difficult to access or understand.
2018 survey Proposed health care providers do not always know which patients are best suited for these programs due to the lack of clear information about eligibility and benefits.
Hanan said companies need to make it easier for people without insurance to get free COVID-19 vaccinations through patient assistance programs.
“If we make it difficult and let us jump through multiple hoops, the vaccine uptake probably won’t be where we want it to be,” Hannan told CNBC.