COVID funding becomes inadequate for the uninsured

The uninsured and the doctors who treat them are among those already excluded as the political battle over COVID funding rages on Capitol Hill.

The Senate’s recent announcement of a $10 billion plan to combat the COVID-19 pandemic comes at a time when cases are rising in some states and the country is facing a possible new wave of BA.2 omicron subvariant infections. , which already accounts for nearly three out of four new cases in the United States.

Even if Congress overcomes an impasse on immigration and adopts the budget deal, a government program that reimburses doctors for diagnosing, treating and providing immunizations to uninsured Americans has run out of money, and the plan includes no money to continue those efforts.

This will put further pressure on important health care providers, such as safety net hospitals and community health centers, which are already operating on razor-thin margins, and will worsen existing health inequalities among the populations they serve. .

Melissa Mather, director of communications for Family Health Centers, Inc., a nonprofit community health center based in Louisville, Kentucky, says, “This is not a great time for us to lose money.”

According to the deal summary, $5 billion of the planned money will go toward treatments, with another $750 million set aside for vaccine research and development for new variations, as well as for vaccine manufacturing.

However, the plan does not include funding for the Health Resources and Services Administration’s program for the uninsured, which last month stopped accepting claims for reimbursement from health care providers for COVID-19 testing and treatment of individuals. uninsured “due to lack of appropriate funds.” The deadline for reimbursement claims related to the administration of vaccines was last Tuesday.

The HRSA program has funded more than $18 billion to help the uninsured gain access to important treatments for COVID-19, according to Lisa Kidder Hrobsky, senior vice president of federal relations, lobbying and political affairs at the American Hospital Association. . While she supports the latest budget relief plan, she believes she misses an opportunity to address growing concerns that a reduction in resources to fight the pandemic could hamper continued attempts to vaccinate people in the most vulnerable communities.

“While we appreciate the assistance that Congress and the administration have offered to hospitals and health systems,” notes Kidder Hrobsky, “we are not pleased that this most recent round of COVID-19 relief does not address long-standing concerns. dates from the hospital field.”

Federal officials have ordered that COVID-19 vaccines be distributed at no cost to the public, even though the government has already procured the country’s current supply. While Medicaid coverage can help cover the costs of COVID-19 services for the uninsured in some states, as an analysis by the Kaiser Family Foundation points out, suspending the reimbursement program will put some providers in the position of having to choose between continuing to provide immunizations or services such as testing the uninsured and absorbing the costs, billing some services as allowed, or simply stopping providing services they previously provided.

According to the KFF summary, “however providers respond, the effect will almost certainly be restricted access for uninsured patients in most states due to more limited provider availability and/or potential out-of-pocket costs.” pocket”.

In the Louisville area, where Family Health Centers cooperated with a private testing company to operate four COVID-19 testing facilities that provided more than 50,000 free tests, Mather says the suspension of the program has already changed services.

Mather describes the testing company’s interaction with him as positive. The organization also handled administrative tasks such as paying for health insurance and filing claims for reimbursement with the Health Resources and Services Administration to screen the uninsured.

“We really looked at that situation and wondered if this was the best situation for what we’re trying to do,” says Mather, “which is provide access in underserved neighborhoods for low-income people who may or may not have health services. sure.”

As a result, Family Health Centers ended the collaboration and now tests solely within its own sites, where administrative costs are around $20. According to Mather, the lower costs allow the health center to provide the treatment at a reduced rate or for free to patients who cannot afford it.

“We thought we were at a point where there wasn’t a lot of demand,” says Mather, “and that we could take it on and provide more access to testing at lower costs.”

The Family Health Centers, according to Mather, are committed to vaccinating people regardless of their financial situation. However, he acknowledges that the health center will need to find other ways to cover administrative costs, which could include covering the costs of tests and treatment through private insurance, Medicare, or Medicaid, or helping patients apply for eligibility to pay for those services through the health center’s sliding fee scale.

“We’re not going to leave our neighbors in the lurch,” says Mather, “but we’re not going to lose that extra support.”

Suspension of the payment program across the country has the potential to create or exacerbate inequalities in communities where access to health care is limited to the local pharmacy.

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