Uninsured People Are Left Behind as Government COVID-19 Funding Dries Up

After two years of free COVID-19 tests, vaccinations, and other health care resources during the pandemic, the government has run out of funding. Last month, the Biden administration wrote a letter to Congress asking lawmakers to provide $22.5 billion to keep the funding programs running across the U.S. Without the additional funding, it “will leave us unequipped to deal with a future surge,” the letter read.

Since January 2022, more than 60 million households across the country have ordered free at-home COVID-19 tests and had access to free testing sites across 21,500 locations around the country. U.S. residents also received free vaccinations and booster shots at 90,000 locations across the country. Moreover, areas populated by communities of color and low-income families have the highest demand for federally funded COVID-19 care.

Those who don’t use the clinics offered by the government typically go to hospitals, pharmacies, or health clinics for COVID-19-related services. But without government funding, people without health insurance have limited options for seeking care and are forced to look for community-based care options, find providers willing to absorb the bill, or pay out of pocket.

Ramifications of Reduced Funding

In the Biden administration’s letter to Congress, officials said it will be “too late” if Congress waits until there is another surge to provide funding. The letter also addresses several consequences arising from the lack of sustained funding, some of which include:

  • Not having enough booster shots.
  • A lack of funding to research additional vaccines that could provide protection against future variants.
  • Scaling back preventative treatments for the immunocompromised individuals.
  • Being “blindsided” by future variants.

Not only will the lack of funding affect currently infected individuals, but it also “increases the possibility of spread, putting more of the population at risk,” said Dr. Georges C. Benjamin, the executive director of the American Public Health Association. “This can raise the chance of more threatening variants becoming widespread.”

Despite repeated requests, additional COVID-19 resources haven’t been approved. Instead, Republican senators are asking the Biden administration for a detailed account of how the previous round of funding was spent.

Without government funding, the cost for a COVID-19 test can run from between $20-850, with $127 being the median cost. There has recently been a reduced demand from citizens who can no longer afford to pay for COVID-19 tests and other health care resources out of pocket, which has made it increasingly difficult for some testing sites to operate. As a result, many states and health care organizations have resorted to shutting down.

New Hampshire closed all state-managed COVID-19 vaccination sites at the end of March, stating vaccination numbers were high enough. In San Diego, officials closed the Jacobs Center vaccination site because of a decline in requests for testing and vaccinations, and instead opened up mobile clinics. For now, they’re still offering tests free of charge despite federal funding running out.

Embry Health, a leading COVID-19 testing provider in Arizona, recently announced it would suspend testing at 60 sites and ask individuals without insurance to pay $100 for COVID-19 tests and $200 for rapid PCR tests at the remaining locations.

“Embry was paying for the uninsured to get tests after the government funding stopped on March 22, 2022, but as of April 2nd, can no longer afford to do so,” the company said in a statement.

CDR Health, a Florida-based company that offered COVID-19 tests to nearly 15,000 people a day during surges, has also closed down all 30 of its free testing centers due to lack of funding.

Reduced Funding Will Widen Health Inequities

Survey data estimates there were 28-31 million uninsured people in the U.S. in 2020, and as many as 14.4 million people will be at risk of losing their health insurance coverage when the public health emergency ends. So while paid testing will continue to be available, it won’t be affordable or accessible for everyone, especially for marginalized communities who already face systemic health care bias. In the U.S., communities of color and low-income families accounted for a disproportionate number of COVID-19 cases and deaths, and experts say the lack of funding will further widen these health and economic inequities.

“Low-income communities and uninsured individuals, which often includes communities of color, are at the greatest risk because they will not have the financial means or insurance protections to cover vaccinations, testing, and health care if the federal government runs out of money to pay for them,” Benjamin said.

What Happens If a New Variant Arises?

A majority of the U.S. population has received their COVID-19 vaccination doses by now. Data from Bloomberg’s COVID-19 vaccination tracker shows 567 million doses have been administered as of April 13. This may partially explain why fewer people are visiting vaccination centers, but experts warn this does not mean the pandemic is over or that there’s no more need for doses or testing.

“If the BA.2 variant causes big outbreaks or there’s a new variant spreading, we will not be prepared for another surge of infections without federal funding,” Benjamin said.

Without the required funding, the government is unable to purchase further life-saving monoclonal antibody medicines or provide boosters shots and other variant-specific immunizations, said Lyle Solomon, a principal attorney at Oak View Law Group.

“There will be a gradual reduction in the money available to pay doctors and other health care providers who treat those uninsured,” Solomon added.

In situations like these, health care providers will need to absorb the costs of uninsured patients or turn them away, which will widen the gap in access to necessary care. Not having access to free tests and vaccinations will only reduce the number of people getting the shot, which will become a major problem if cases increase again or if a new variant arises.

“We are still not at the optimal level of vaccination, including booster shots,” Benjamin said.

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