Free Covid-19 tests for the public and private: Where do they go? Where do we stand, what do we need, and what can we do about it?
The government website still offers a maximum of four test kits per household, until they run out. The Biden administration shifted funding to purchase additional kits and made them available in late December.
It’s the fourth round of free rapid tests this year. The program was stopped in September by the White House due to the Congress not approving more funding for it. But the administration shuffled around funds to buy more of the tests for the national stockpile, the official said.
“We know that the virus will circulate more quickly and easily as folks gather indoors for the winter holiday season,” the official said, speaking on condition of anonymity. After Thanksgiving, there was an increase in the number of cases, which officials are expecting to see after December holiday celebrations.
Tests are also available at community testing sites, food banks and schools, and through Medicare. People covered by private health insurance plans can get fully reimbursed for eight tests per month.
The federal government has been preparing to shift Covid-19 care to the commercial market since last year, in part because Congress has not authorized additional funding to purchase additional vaccines, treatments and tests.
At Brown University she is the deputy dean of the School of Public Health and a professor of emergency medicine. Her own views are expressed in this commentary. Read more opinion on CNN.
We are currently in the middle of a terrible season of respiratory viruses. Widespread cases of flu, Covid-19, and pneumonia were the reason for more than 10% of deaths in the US last week. We are short on key medications in some places. Hospital overcrowding is a result of severe health care staff shortages. The Covid-19 boosters are still used.
It’s true that four tests per family are not a lot. But they are illustrative of a larger group of ongoing wins against Covid-19 – outside of vaccination – that should be celebrated, and then examined closely for lessons learned.
There’s more to do with the epidemic, it isn’t over. Regardless of how small your circle is, it’s still very possible to contract and spread Covid-19. Getting tested regularly and wearing an N95 face mask are ways to help prevent this. While there are free testing sites in the US, there are also places where you can take a Covid test at home and get results in 15 minutes or less.
It may be tough to remember now, but it wasn’t until the spring of 2021 that at-home testing even became available to the public. Then, they were expensive and difficult to find. Huge differences in use were seen in the early months. Minorities, the elderly and low-income people were less likely to use them.
That brings us to the second piece of good news to pay attention to: Between December 2021, when the FDA provided authorization for emergency use of Paxlovid, and now, the proportion of eligible patients treated with oral antivirals after a Covid-19 diagnosis increased from less than 1% to about 40%. The improvements likely reflect the dramatic expansion of test-to-treat programs over the last few months. Under the urging of the federal government, in-person, telehealth, and pharmacist-led programs have shortened the time and effort between diagnosis and provision of a prescription. Private businesses, such as eMed, are also providing these services.
Of course, for testing to make a difference, people need to act on positive Covid diagnoses. For people who are older, pregnant, or otherwise at high risk of having bad outcomes, Paxlovid are an important part of that action. Recent real-world data shows that during the Omicron wave, Paxlovid recipients had approximately 50% lower rates of hospitalization than those who didn’t receive it – even accounting for age, prior vaccination and infection, co-existing illnesses and the like. Experiments confirm efficacy against new variants.
Better yet, just last week, a new partnership was announced between Walgreens, Uber Health and DoorDash to facilitate the timely delivery of Paxlovid to those who cannot get to the pharmacy. According to Walgreens, this program can reach 92% of Americans. In combination with existing prescription delivery services from CVS and RiteAid, this newest partnership may reduce the chance that someone sick has to go out and expose others in order to get their Paxlovid prescription. It also provides immense benefit to those who can’t get transportation or child care or are disabled.
Partly due to bureaucracy, there remains no FDA-approved rapid antigen or molecular home tests for influenza or RSV. Additionally, oseltamivir (commonly known as Tamiflu) is not as effective as Paxlovid, and there are no good treatments for RSV. Moreover, telehealth has already been shown to increase over-prescription – and unnecessary prescription – of some treatments, such as antibiotics; any wider scale test-to-treat program would have to be careful to make sure it doesn’t further worsen overuse of antivirals and antibiotics. And as opposed to payment for Covid-19 tests and treatment, access to other types of telehealth and medications is largely dependent on one’s insurance – or ability to pay out of pocket.
Maybe, just maybe, both the failures and the small successes we’ve seen in the midst of Covid-19 can lead us to a space where even more public health innovation can occur.
At the same time, we also have developments to celebrate this holiday season. We now have some amazing new tools that reduce disease and severe illness, and they’re truly available to all.
With hundreds of options, it’s tough to know which one to buy (if they’re even in stock). We rounded up options based on availability and FDA authorization to help make the search simpler. You can also now order the third round of free at-home tests from the US government (if you haven’t already). Members of our team have used some, but not all, of these tests.
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Within 15 minutes, Abbot can provide your results from your nose sample with the included test card. You can then use Navica, the companion app, to self-report your results. If you test negative, a temporary digital pass will be sent to you and you can use it as proof of your test result. If there are two tests in a box, the company recommends taking the second test no later than 48 hours. A few members of the Gear team have used this test. It was straightforward to use, but we do not have the ability to verify its level of accuracy.
An official in the White House said that a successful vaccine campaign and reductions in Covid cases were the reason for lifting the emergency declarations. The official said that a final extension would allow for a smooth transition for health care providers and patients and noted that health care facilities have already begun preparing for that transition.
The statement said that the wind down would be in line with the administration’s previous commitments to give at least 60 days’ notice before the public health emergency ends.
The White House weighed in because House Democrats were concerned about voting against the Republican legislation to end the public health emergency that is coming to the floor this week without a plan from the Biden administration, a senior Democratic aide told CNN.
The administration argues that the bills are unnecessary because it intends to end the emergencies anyway. The White House felt the passing of the measures prior to May 11 would have consequences, such as disrupting the administration’s plans to end certain policies that are authorized by emergencies.
The administration wants to find out which policies can remain in place after the public health emergency is lifted.
The aide told CNN that the legislation will be up to each member to decide if it’s in their best interest for their district or not. The border restriction known as Title 42 will likely be set up by declaring an end to the public health emergency.
According to Jen Kates of the Kaiser Family Foundation, “People will need to start paying money for things they didn’t have to pay for during the emergency.” “That’s the main thing people will start to notice.”
Medicare beneficiaries, those enrolled in Medicaid — the state-federal health insurance program for people with low incomes — and people who have health plans via the Affordable Care Act exchanges will continue to get COVID-19 vaccines without charge, even when the public health emergency ends and the government-purchased vaccines run out. Most people with job-based insurance do not have to pay copayments for vaccines if they go out-of-network.
The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. When the federal funding ran out in the spring of 2022, it became more difficult for people without coverage to get free services.
Sean Robbins, the executive vice president of external affairs for the Blue Cross Blue Shield Association, said that if you are not insured or uninsured, it will be very hard to come up with a price for vaccine that is more than $100. He said that those increases will affect people with insurance as costs “flow through to premiums.”
The public health emergency has also meant additional funds for hospitals, which have been receiving a 20% increase in Medicare’s payment rate for treating Covid-19 patients.
Also, Medicare Advantage plans have been required to bill enrollees affected by the emergency and receiving care at out-of-network facilities the same as if they were at in-network facilities.
But several of the most meaningful enhancements to public assistance programs are no longer tied to the public health emergency. As part of its government funding package, Congress disconnected the connection in December.
Another complication: The rolls of the uninsured are likely to climb in the next year, with states poised to reinstate the process of regularly determining Medicaid eligibility; that sort of review was halted during the pandemic. In April, states will begin reassessing whether Medicaid enrollees meet income and other qualifying factors.
The Department of Health and Human Services released an analysis in August that estimated that roughly 15 million people could be dropped from Medicaid once the continuous enroll requirement ends. About 8.2 million folks would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the department estimated.
During the public health emergency, food stamp recipients had been getting a boost. Congress increased food stamp benefits to the maximum for their family size in a 2020 pandemic relief package.
The boost was expanded so that households already receiving the maximum amount and people who only received a small monthly benefit get a supplement of at least $95 a month, in the spring of 2021.
Is Telehealth Covering the Public Health Emergency? Investor Perspectives on Vaccinations and Telemedicine in the 21st Century, as Revealed by BioNTech
More Medicare enrollees are able to get care via telehealth during the public health emergency. The service is no longer limited just to those living in rural areas. They can conduct the telehealth visit at home, rather than having to travel to a health care facility. It’s more convenient for beneficiaries to get a wider array of services via Telehealth.
Even though Paxlovid’s copay is the same as other drugs, experts say many private insurers will still cover it. Medicaid will not cover it at all until at least 2024.
People with limited-benefit or short-term insurance policies might have to pay for all or part of their vaccinations. It will cost people without insurance full cost to get vaccinations from community clinics or other providers. If they cannot find a free or low-cost option, some uninsured patients may feel forced to skip vaccinations or testing.
Ryan Richardson, chief strategy officer for BioNTech, told the investors at the San Francisco conference that they saw a double-digit billion dollar market opportunity. The company expects a gross price — the full price before any discounts — of $110 a dose, which, Richardson said, “is more than justified from a health economics perspective.”
Even if people don’t take the vaccine, it would translate to a lot of money for the manufacturers. Consumers will either directly or indirectly pay the bill, through higher premiums and taxpayer-funded subsidies.
COVID Tests and Coverage in the U.S. Health System: Why Does It Need To Be Served? The Kaiser Health News Report
“This is our No. 1 concern” right now, said John Baackes, CEO of L.A. Care, the nation’s largest publicly operated health plan with 2.7 million members.
There is a complicated mix of coverage consumers already navigate for most other types of care, and this will be reflected in the future of COVID tests.
“For treatment and test kits, some people will have to pay for it,” said Jen Kates, a senior vice president at KFF. Universal access is gone and we’re going back to how it was in the regular U.S. health system.
KHN’s correspondent was involved in the report. KHN (Kaiser Health News) is a national, editorially independent program of KFF (Kaiser Family Foundation).