Coverage for all dries up even as hospital costs up

WASHINGTON » For the first time, the U.S. came close to providing health care for all during the coronavirus pandemic — but for just one condition, COVID-19.

Now, things are reverting to the way they were as federal money for COVID-19 care of the uninsured dries up, creating a potential barrier to timely access.

But the virus is not contained, even if it’s better controlled. And safety-net hospitals and clinics are seeing sharply higher costs for salaries and other basic operating expenses. They fear they won’t be prepared if there’s another surge.

“We haven’t turned anybody away yet,” said Dr. Mark Loafman, chair of family and community medicine at Cook County Health in Chicago. “But I think it’s just a matter of time.”

A $20 billion government COVID program covered testing, treatment and vaccine costs for uninsured people. But that’s been shut down. At Parkland Health, the frontline hospital system for Dallas, Dr. Fred Cerise questions the logic of dialing back federal dollars at a time when health officials have rolled out a new “test-to-treat” strategy. People with COVID-19 can now get antiviral pills to take at home, hopefully avoiding hospitalization.

“Test-to-treat will be very difficult for uninsured individuals,” predicted Cerise, president and CEO of the system. “If it’s a change in strategy on the large scale, and it’s coming without funding, people are going to be reluctant to adopt that.”

Officials at the federal Department of Health and Human Services say the new antiviral drugs like Paxlovid have been paid for by taxpayers, and are supposed to be free of charge to patients, even uninsured ones.