Arizonans have reason to worry about COVID-19 costs

A lapse in federal funding means some health care providers in Arizona are trying to figure out how to continue offering free COVID-19 testing and vaccines.

Monday, Phoenix-based Embry Health said it has suspended operations at 60 of its Arizona testing sites.

“If people do not have free COVID-19 testing available, they will not get tested, putting families and loved ones at risk,” Embry CEO Raymond Embry said in a written statement.

“Therefore, Embry Health continues to encourage Congress to authorize additional timely funding for COVID-19 testing, treatment, and vaccinations.”

For now there are still places doing COVID-19 tests and giving COVID-19 vaccines (including booster shots) at no cost, no matter one’s insurance status. But there’s a lot of uncertainty about how those free services will continue.

“Community health centers will continue to treat patients, regardless of their ability to pay,” Jennifer Burns, senior director of government and media relations for the Arizona Alliance of Community Health Centers, wrote in an email. “However, additional funding will be needed to meet the needs of our most at-risk communities.”

A corporate spokesperson for Walgreens wrote Thursday in an email the national retail pharmacy chain does not have specifics about future consumer costs for COVID-19 tests and vaccines.

“We await further guidance from the administration and federal agencies and are hopeful for a path forward that ensures uninterrupted access to COVID-19 services,” a corporate statement says.

COVID-19 tests conducted at pharmacies and clinics could cost consumers without health coverage more than $100 each.

Embry said the federal funding shortfall poses serious problems, particularly now that the BA.2 variant of COVID-19 could cause another spike in infections, as it has done in other parts of the world.

“It’s extremely concerning. This is the worst possible thing to happen in the COVID-19 pandemic response since almost ever,” said Embry, whose company has COVID-19 testing sites across Arizona.

This funding is critical to ensure the testing and vaccine infrastructure built by labs and providers across America remains available for all patients, regardless of insurance status.”

A Politico article published Monday reported that the U.S. Senate is close to reaching a $10 billion compromise COVID-19 aid package, but it’s not a done deal and the package would would need to get the approval of the U.S.

House of Representatives.

The compromise package would reprogram billions in unused money from other coronavirus bills to deliver funding for therapeutics, testing and vaccine distribution, Politico reported.

Clinics are a good bet for free tests and vaccines

A U.S. Health Resources and Services Administration COVID-19 Uninsured Program stopped accepting reimbursement claims for COVID-19 testing and treatment services on March 22 and is scheduled to stop accepting claims for vaccine administration on April 5.

“Provider policies will dictate whether they bill patients directly for these specimen collection and/or laboratory testing and the price they will charge. Not every provider will charge a fee for testing,” Jessica Rigler, who is assistant director for the department’s division of public health preparedness, wrote Thursday in an email.

“The COVID-19 vaccine is free, but some providers may charge an administration fee for administering the shot. To date, this has been covered by a patient’s insurance, or through the federal HRSA program allowing providers to bill HRSA for uninsured patients. Our understanding is that this HRSA program will end in the next week.”

State and local health departments contract directly with testing and vaccine providers to ensure Arizonans get services at no cost, Rigler said. In addition, other providers, including community health centers and county health department clinics, may offer those services at low or no cost, she said.

Estimates on how many Arizonans are uninsured vary. Dr. Dan Derksen, University of Arizona public health professor, puts the number at about 700,000 people, which is close to 10% of the population, though other estimates put the number at 800,000 people or higher.

Burns of the Arizona Alliance of Community Health Centers said Sens. Kyrsten Sinema and Mark Kelly, both Arizona Democrats, have been working to get more supplemental COVID-19 funding from Congress.

“Hopefully, the problem will be quickly resolved,” Burns wrote.

A March 31 letter to U.S. Senate and House leaders from members of Arizona’s Democrat Congressional delegation says more funding is needed to ensure health providers caring for Arizona’s most vulnerable residents “are able to remain operational.”

The HRSA funding has been a “lifeline” for many health providers, the letter says, and calls the need for additional relief is “dire.”

The letter says that Arizona has received just $227 per capita in federal COVID-19 provider relief funds, which it says is the third-lowest among all states and Washington, D.C.

‘From a public health perspective we need patients to continue getting tested’

About 50% of Embry Health’s patients are uninsured, officials said. And Embry Health’s testing sites had 14,000 appointments between March 24 and March 30, officials said.

Embry currently tests approximately 2,200 people a day which is down from 46,000 daily at the height of the omicron spike earlier this year.

Embry was paying for the uninsured to get tests after the government funding stopped on March 22, 2022, but can no longer afford to do so.

“This is devastating because we’re still owed a substantial amount of money from the last surge,” Raymond Embry said. “We’re at the cusp, potentially, of heading into another surge. There are warning signs everywhere and from a public health perspective we need patients to continue getting tested.”

A March 28 report from the Kaiser Family Foundation says the funding problem could prevent some people from getting tests, vaccines and treatment for COVID-19. It also says that once the current supply runs out, the federal government cannot purchase more tests, treatments or vaccines without additional congressional appropriations.

“Without federally purchased supplies, uninsured individuals would likely need to pay out of pocket for testing and treatment services and/or safetynet providers would have to absorb the cost of providing these services without a reimbursement mechanism,” the report says.

People with private insurance could be affected if costs shift to private insurers, according to the report.

“... The insurers will need to establish new contracts and negotiate prices to purchase these supplies, which will take time and may lead to higher costs that could translate into higher premiums for employers and individuals,” it says. “Insurers may also have a difficult time competing with other countries in purchasing vaccines.”