Federal COVID Funding for Uninsured Americans Is Running Out—And Many May Lose Access to Testing and Treatment

The program's end stands to impact millions of individuals and the country's fight against COVID-19.

In an aerial view, cars wait in line at a Bluewater Diagnostic Laboratories drive through COVID-19 testing site at Churchill Downs on January 10, 2022 in Louisville, Kentucky.
Photo: Getty Images

As the nation's approach to addressing the coronavirus crisis continues to evolve, perhaps one of the most concerning recent developments is the lack of continued federal funding for uninsured COVID patients.

A White House fact sheet issued earlier this month pointed out that as the country shifts into this next phase of pandemic response, Congress has not provided the funding necessary to continue to reimburse doctors and other medical providers who care for uninsured individuals. Specifically, providers are no longer "able to submit claims for testing, treating, and vaccinating the uninsured," according to the White House.

As a result, the fund, which was established in 2020 and has been used up until now to reimburse doctors and other healthcare providers, began scaling back reimbursements throughout March and will completely end the payments in early April. While the White House administration has requested an additional $22.5 billion in emergency funding from Congress, there has yet to be a response.

This reality has broad ramifications for uninsured patients and for the country's efforts to address COVID-19.

"Providers will no longer be able to submit claims for providing these services to uninsured individuals, forcing providers to either absorb the cost or turn away people who are uninsured, increasing the disparity in access to critically needed health care and putting additional burdens on safety net providers," according to the White House statement.

Here's a closer look at the funding challenges and the potential fallout for those without health insurance, as well as for the nation's fight against COVID-19.

What Is the Current Status of the Uninsured Program?

The Health Resources & Services Administration (HRSA), website provides further guidance on how the lack of funding from Congress is impacting the reimbursement fund for uninsured COVID-19 patients.

In particular, the HRSA website states that "The Uninsured Program has stopped accepting claims for testing and treatment due to lack of sufficient funds," adding that any confirmation from the agency of receipt of a claim submission does not mean that the claim is going to be paid. As of March 22, claims for testing or treatment were no longer being processed for adjudication or payment.

The end of vaccination reimbursement claims is also coming soon. The HRSA website states that after April 5, the Uninsured Program will also stop accepting those claims as well due to the lack of funding.

None of these changes impact consumers who have private insurance or who are covered by Medicare or Medicaid.

However, the Uninsured Program is essential on both a state and national level when it comes to covering those without insurance. At the beginning of 2021, more than 31 million Americans were uninsured, according to Statista.

"The HRSA Program really is a benefit for an individual that is uninsured because it decreases some of the disparities for access to healthcare," Laura Owens, PharmD and CEO of Carolina Family Health Centers, told Health.com. "A person without insurance has a lack of access and the loss of this program may impact uninsured individuals."

The Carolina Family Health Centers serve not only local patients but also seasonal farm workers that relocate to the area. The HRSA Program assisted the clinic in its ability to offer free COVID-19 testing and vaccinations.

"Since the demand for testing as of now is low, we may be able to absorb the costs," Owens added. "However, with experts giving us warning against a new variant, as demand increases, the ability to absorb costs may become less likely."

The concerns expressed by the Carolina Family Health Centers executive are not unique. They are merely one example of a story now being played out across the nation amongst healthcare and medical services providers who are facing the realities of treating uninsured COVID-19 patients without financial support from the federal government.

Financial Fallout for the Uninsured

The lack of funding for the HRSA program means that everything from testing to getting vaccinated and treated for COVID-19 can become an unexpected out-of-pocket expense for uninsured Americans. To put that in some perspective, during the course of just one year—2021—the fund spent $130 million covering the testing, treatment, and vaccinations of uninsured individuals.

The New York Times recently reported that "U.S. health care providers are informing uninsured people they can no longer be tested for the virus free of charge and will have to pay for the service."

Meanwhile, Quest Diagnostics, which operates testing sites and labs across the country, states on its website that the out-of-pocket cost of being tested for COVID-19 with QuestDirect without insurance will cost $125.

The cost of hospital care for the uninsured is especially concerning. According to a FairHealth study titled COVID-19 Treatment and Hospitalization Costs, which was published in December, the cost for a hospital stay in 2020 and 2021 ranged from $49,000 to a whopping $128,650. That estimate is based on an analysis of private healthcare claim records from April 2020 to August 2021.

"I worry about people who need hospital care. It could be financially devastating to those that are uninsured," Colleen Meiman, national policy advisor for state and regional associations of Community Health Centers, told Health.com.

Meiman is not alone in her concerns. "With an absence of funding, I worry about the disproportionately low-income uninsured being able to access the services they need," Brendan Riley, director of policy at the North Carolina Community Health Center, told Health.com.

Ramifications for the Fight Against COVID-19

Yet another pressing question at this juncture is whether the lack of funding for the uninsured will create a backslide in the fight against COVID-19, especially as the BA.2 variant becomes a growing concern. Health experts say the lack of funding will certainly be counterproductive.

"Without the program, it will discourage people that are uninsured from seeking out services such as testing and getting vaccinated. If people quit getting tested, it can result in an increase in spread," Meiman said.

This reality is not lost on the White House, which has requested $22.5 billion in emergency COVID funding. Even the American Hospital Association penned a letter last week on behalf of its nearly 5,000 member hospitals urging congress to provide additional funding for the program.

"While the nation remains weary and is eager to move past this pandemic, the virus continues to evolve and pose a threat to our nation's health care system," states the letter, signed by Stacey Hughes, the organization's executive vice president. "The recent surge of cases and hospitalizations abroad fueled by the Omicron variant known as BA.2 serves as a critical warning: The battle is not over, and hospitals and health systems continue to need resources and flexibilities to care for patients and protect communities.

Thus far however, Congress has said it has no plans to approve more aid. It's an unsettling prospect for those in the medical community.

"There is still a need for ongoing testing. Plus, we need to be prepared in case there is another wave from new variants," said Riley. "Another concern is keeping up with the demand for vaccinations and boosters once there is approval for children under five years old."

Where Can the Uninsured Seek Assistance?

So, where can uninsured Americans turn to for healthcare assistance now that funding has ended? Owens suggested that such individuals should start by reaching out to community health centers that provide services to patients without health insurance. The Carolina Family Health Center, for instance, provides a sliding fee discount program that's based on the individual's income. Programs like this one can be helpful to uninsured patients, Owens said.

The HRSA website also includes a handful of suggested resources for uninsured individuals and medical providers to turn to after the Uninsured Program winds down. These include Medicaid enrollment, healthcare marketplace enrollment, COVIDTests.gov and finally HRSA.gov—Find a Health Center.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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