The Biden administration is facing criticism in response to an initiative announced on Monday, which would allow only people with private health insurance to get reimbursed for at-home COVID tests starting this weekend.
The plan requires private insurers to reimburse their customers for up to eight at-home COVID tests per month per person, and “incentivizes” insurers to cover the costs up front, according to the Department of Health and Human Services (HHS).
But the initiative has faced widespread scrutiny from progressive lawmakers and advocates, as it provides few options for uninsured people or individuals on Medicare to access at-home tests, even as the nation nears the end of its second year of the pandemic. This could end up furthering already-wide disparities between pandemic outcomes for people with insurance and without; as one report found last year, about 33 percent of COVID deaths and 40 percent of infections have been linked to a lack of health insurance.
Tests for all, just like vaccines for all. Why are they making this so complicated? https://t.co/wFwY4B3nGI
— Morgan Harper (@mh4oh) January 11, 2022
Rep. Cori Bush (D-Missouri) said that the disparities inherent in the administration’s plan lend further evidence to the argument that the country should embrace Medicare for All. “Free at-home rapid tests in the middle of a record-breaking COVID surge should not just be a privilege for the insured,” she wrote on Monday. “We need free at-home rapid tests for all. We need Medicare for All.”
People can still visit a local testing site to get tested for the virus. But even though tests at clinics or other health care centers are supposed to be free or low-cost for all, many people have reported receiving bills for tests anyway; one person in Dallas, NPR reported, got a bill for $54,000 after getting a PCR and antigen test at a free-standing emergency room 30 minutes from home. Loopholes in the CARES Act policy that mandated that tests should be paid for by insurance have allowed providers to charge high costs to insurance – costs that insurance won’t necessarily pay out.
Costs aside, visiting a testing site may be infeasible for some people. Fatigue is a common COVID symptom, meaning that the person affected may not have the energy to transport themselves to a site or wait in long lines to be tested. Although PCR tests are more accurate than rapid antigen tests, getting back PCR results could take days, during which people may end up infecting others – especially because many don’t have the option to stay home from work while they wait for results.
Though the administration also said in its Monday announcement that it would be sending 50 million tests to community centers and clinics that partner with Medicare to distribute for free, this amount isn’t enough to cover even just Medicare beneficiaries; about 62 million people are enrolled in Medicare. Meanwhile, about 28 million people didn’t have health insurance at any point in 2020, according to the Census Bureau.
Even for people with private insurance, the program may prove complex. As some reporters have pointed out, getting private insurers to reimburse customers can be difficult. A shortage of antigen tests is also skyrocketing prices for at-home tests, meaning that paying for eight tests at once could cost at least $80 before tax for the cheapest tests – money that many people can’t afford to lose for the indeterminate amount of time it may take insurance to reimburse them.
It’s unclear why the administration is choosing to roll out this program now, after the holidays and lax regulations have swung the country into its most infectious wave by far. According to the New York Times, 737,000 people on average are testing positive for COVID per day, not including the countless at-home positive tests that many people aren’t reporting. This is nearly three times the previous daily high of about 250,000 cases per day last winter.
This isn’t the first time the Biden administration has faced scrutiny over the president’s relative failure to stem the spread of COVID-19 during his first year in office. In December, for instance, Vanity Fair uncovered that the administration rejected a proposal that would have given out hundreds of millions of free at-home tests to people ahead of the holidays in order to prevent the current surge.
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