Biden Administration Will Fund Program to Keep Covid Vaccines Free for the Uninsured

By Sheryl Gay Stolberg and Noah Weiland

On April 18, 2023

The program, which will include a partnership with pharmacy chains, will help cover the cost of vaccinating patients when the shots move to the commercial market later this year.

WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to offer free coronavirus shots to uninsured Americans after the vaccines move to the commercial market later this year, administration officials said on Tuesday.

The program for the uninsured, which will be modeled partly on an existing childhood vaccination program and will cover an estimated 30 million people, will include a first-of-its-kind partnership with pharmacy chains in which the government will pay the administrative costs of giving the doses to patients. Pfizer and Moderna have pledged to offer the shots at no cost to those who lack insurance.

The administration’s move partly resolves a critical gap in the nation’s coronavirus vaccination strategy ahead of a new booster campaign with reformulated shots that is likely to begin as soon as late summer. Federal officials have said that they no longer plan to purchase doses for all Americans as they have in prior coronavirus vaccination campaigns, allowing the vaccines to be sold commercially and ceding power to manufacturers to set their own prices.

For the new program, the administration is counting on substantial help from the companies making the vaccines. In February, Moderna said it would use a so-called patient assistance program to provide doses free of charge to uninsured Americans. Pfizer plans to offer free vaccines through a similar program, a company spokeswoman said.

The details of those programs are still being worked out. Jennifer Kates, a senior vice president at the Kaiser Family Foundation, said pharmaceutical company assistance programs varied by company and medication, a patchwork system that can be complicated and inaccessible. Companies often require proof of income or proof that a patient is uninsured, Dr. Kates said, and it is unclear how long the drugmakers’ programs might last.

“It’s a Band-Aid,” she said. “The problem is that these are not mandatory or sure bets. These are voluntary efforts by companies.”

But Xavier Becerra, President Biden’s secretary of health and human services, said it was in the companies’ interest to keep the programs going.

“It’s their business sense,” Mr. Becerra said in an interview. “The last thing they want is to become the object of derision because people are saying: ‘What gives? All of a sudden we’re having to pay to get this vaccine?’”

The new vaccine initiative comes as the administration is looking beyond the coronavirus public health emergency, which was declared under President Donald J. Trump in 2020 and has been extended under Mr. Biden. The administration plans to allow the emergency to expire on May 11, setting the nation on a course for Covid-19 to be treated as just another respiratory disease, like influenza.

The new initiative will also cover some costs associated with Covid-19 treatments for the uninsured. In addition, the administration is working on a $5 billion program to spur next-generation coronavirus vaccines and treatments.

“Covid is not over,” said Dr. Ashish K. Jha, the White House coronavirus response coordinator. “And while we are transitioning out of the public health emergency and all of the flexibilities it provided, we’re committed to making sure that we continue to fight Covid. And that means making sure people have access to vaccines, treatments and tests.”

The end of the public health emergency will not have any immediate impact on Americans’ ability to gain access to coronavirus vaccines. For now, people can still get shots at no cost from the stockpile of doses the federal government has already purchased. On Tuesday, the Food and Drug Administration authorized a second updated booster shot for people 65 and older or those who are immunocompromised.

In June, federal regulators are expected to choose a new formulation for use in another round of booster shots later in the year, around the time people receive their annual flu shot.

As part of the new initiative, called the H.H.S. Bridge Access Program for Covid-19 Vaccines and Treatments, federal officials will also purchase vaccines and distribute them to state and local health departments to be given to the uninsured.

When coronavirus vaccines move to the commercial market, Pfizer and Moderna have said they plan to charge over $100 per dose, or roughly four to five times the price the federal government paid for the companies’ shots in the most recent booster campaign. Dr. Jha said White House officials “don’t think that kind of price increase is justifiable.”

But Mr. Becerra conceded there was little the administration could do. “We don’t control the commercial market,” he said.

For most Americans, the reformulated shots later this year will not bring any out-of-pocket costs. Most private health plans will cover them, as will Medicare and Medicaid. The costs of doses for uninsured children will be covered by the federal Vaccines for Children program.

The Biden administration has proposed creating a program called Vaccines for Adults, which would mimic the concept used for uninsured children. But administration officials have been unable to persuade lawmakers to establish such an initiative.

This piece was republished from The New York Times.