|Congress has passed and the President has signed emergency relief measures eliminating costs for testing, preventive services, and an eventual vaccine (but in most cases, not for treatment) as follows:
- The Families First Coronavirus Response Act (Families First) requires free COVID-19 diagnostic testing, provides $1 billion for the National Disaster Medical System to reimburse providers for COVID-19 testing and testing-related visits for the uninsured, and creates a new optional Medicaid eligibility pathway for states to cover COVID-19 testing and testing-related services for uninsured individuals with 100% federal matching funds (although immigrants still face restrictions on eligibility for Medicaid). As a condition of receiving Medicaid enhanced federal matching funds during the public health emergency, states must cover COVID-19 testing and treatment, including vaccines, specialized equipment, and therapies, without cost-sharing.
- The Coronavirus Aid, Relief, and Economic Security Act (CARES) expands no-cost provisions for testing, prevention, and an eventual vaccine to all payers. The Trump administration is reimbursing providers for treating uninsured patients with a primary diagnosis of COVID-19 by tapping $175 billion in grant funding for hospitals and other health care entities. The administration has said it would also use this fund to pay providers to administer a COVID-19 vaccine to uninsured patients. While the CARES Act requires insurers to cover the costs of an eventual COVID-19 vaccine, it does not address vaccine pricing (nor does other federal legislation). Administration officials have said they would ensure access but do not want to impose price controls.
- The Paycheck Protection Program and Healthcare Enhancement Act (Paycheck Protection) provides $11 billion in funding to states and localities for testing and contact tracing and up to $1 billion to cover the cost of testing for the uninsured.
|Biden would work to eliminate cost-barriers (co-payments, deductibles, surprise billing) for all COVID-19 services and commodities, including testing, preventive services, treatment, and an eventual vaccine, for both those who are insured and uninsured, by:
- Requiring all private plans (employer plans and individually purchased) to immediately cover all testing, treatment, and preventive services related to COVID-19, and for an eventual vaccine, and ensure that testing is free to everyone regardless of immigration status. On vaccine pricing, Biden would provide explicit authority for HHS Secretary to approve the commercial price of vaccines that are developed in conjunction with federally funded research.
- Applying the same requirement to public plans including Medicare, Medicaid, the Children’s Health Insurance Program, Indian Health Service, Veterans Affairs, DoD’s TriCare program and the Federal Employees Health Benefits (FEHB) Program.
- Fully funding and expanding authority for the National Disaster Medical System (NDMS) to reimburse health care providers for COVID-19-related treatment costs not directly covered by health insurance for the insured as well as uncompensated care incurred by uninsured and underinsured populations.