Era of ‘free’ COVID vaccines, test kits, and treatments is ending. Who will pay the tab now?

Time is running out for free-to-consumer COVID vaccines, at-home test kits, and even some treatments.

The White House announced this month that the national public health emergency, first declared in early 2020 in response to the pandemic, is set to expire May 11. When it ends, so will many of the policies designed to combat the virus’s spread.

Take vaccines. Until now, the federal government has been purchasing COVID-19 shots. It recently bought 105 million doses of the Pfizer-BioNTech bivalent booster for about $30.48 a dose, and 66 million doses of Moderna’s version for $26.36 a dose. (These are among the companies that developed the first covid vaccines sold in the United States.)

People will be able to get these vaccines at low or no cost as long as the government-purchased supplies last. But even before the end date for the public emergency was set, Congress opted not to provide more money to increase the government’s dwindling stockpile. As a result, Pfizer and Moderna were already planning their moves into the commercial market. Both have indicated they will raise prices, somewhere in the range of $110 to $130 per dose, though insurers and government health programs could negotiate lower rates.

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“We see a double-digit billion[-dollar] market opportunity,” investors were told at a JPMorgan conference in San Francisco recently by Ryan Richardson, chief strategy officer for BioNTech. The company expects a gross price — the full price before any discounts — of $110 a dose, which, Richardson said, “is more than justified from a health economics perspective.”

That could translate to tens of billions of dollars in revenue for the manufacturers, even if uptake of the vaccines is slow. And consumers would foot the bill, either directly or indirectly.

If half of adults — about the same percentage as those who opt for an annual flu shot — get COVID boosters at the new, higher prices, a recent KFF report estimated, insurers, employers, and other payors would shell out $12.4 billion to $14.8 billion. That’s up to nearly twice as much as what it would have cost for every adult in the U.S. to get a bivalent booster at the average price paid by the federal government.

As for covid treatments, an August blog post by the Department of Health and Human Services’ Administration for Strategic Preparedness and Response noted that government-purchased supplies of the drug Paxlovid are expected to last through midyear before the private sector takes over. The government’s bulk purchase price from manufacturer Pfizer was $530 for a course of treatment, and it isn’t yet known what the companies will charge once government supplies run out.

How Much Of That Pinch Will Consumers Feel?

One thing is certain: How much, if any, of the boosted costs are passed on to consumers will depend on their health coverage.

Medicare beneficiaries, those enrolled in Medicaid — the state-federal health insurance program for people with low incomes — and people with Affordable Care Act coverage will continue to get COVID vaccines without cost sharing, even when the public health emergency ends and the government-purchased vaccines run out. Many people with job-based insurance will also likely not face co-payments for vaccines, unless they go out of network for their vaccinations. People with limited-benefit or short-term insurance policies might have to pay for all or part of their vaccinations. And people who don’t have insurance will need to either pay the full cost out-of-pocket or seek no- or low-cost vaccinations from community clinics or other providers. If they cannot find a free or low-cost option, some uninsured patients may be forced to skip vaccinations or testing.

Coming up with what could be $100 or more for vaccination will be especially hard “if you are uninsured or underinsured; that’s where these price hikes could drive additional disparities,” said Sean Robbins, executive vice president of external affairs for the Blue Cross Blue Shield Association. Those increases, he said, will also affect people with insurance, as the costs “flow through to premiums.”

Meanwhile, public policy experts say many private insurers will continue to cover Paxlovid, although patients may face a co-payment, at least until they meet their deductible, just as they do for other medications. Medicaid will continue to cover it without cost to patients until at least 2024. But Medicare coverage will be limited until the treatment goes through the regular FDA process, which takes longer than the emergency use authorization it has been marketed under.

Another complication: The rolls of the uninsured are likely to climb over the next year, as states are poised to reinstate the process of regularly determining Medicaid eligibility, which was halted during the pandemic. Starting in April, states will begin reassessing whether Medicaid enrollees meet income and other qualifying factors.

An estimated 5 million to 14 million people nationwide might lose coverage.

“This is our No. 1 concern” right now, said John Baackes, CEO of L.A. Care, the nation’s largest publicly operated health plan with 2.7 million members.

“They may not realize they’ve lost coverage until they go to fill a prescription” or seek other medical care, including vaccinations, he said.

What About COVID Test Kits?

Rules remain in place for insurers, including Medicare and Affordable Care Act plans, to cover the cost of up to eight in-home test kits a month for each person on the plan, until the public health emergency ends.

For consumers — including those without insurance — a government website is still offering up to four test kits per household, until they run out. The Biden administration shifted funding to purchase additional kits and made them available in late December.

Starting in May, though, beneficiaries in original Medicare and many people with private, job-based insurance will have to start paying out-of-pocket for the rapid antigen test kits. Some Medicare Advantage plans, which are an alternative to original Medicare, might opt to continue covering them without a co-payment. Policies will vary, so check with your insurer. And Medicaid enrollees can continue to get the test kits without cost for a little over a year.

State rules also can vary, and continued coverage without cost sharing for COVID tests, treatments, and vaccines after the health emergency ends might be available with some health plans.

Overall, the future of COVID tests, vaccines, and treatments will reflect the complicated mix of coverage consumers already navigate for most other types of care.

“From a consumer perspective, vaccines will still be free, but for treatments and test kits, a lot of people will face cost sharing,” said Jen Kates, a senior vice president at KFF. “We’re taking what was universal access and now saying we’re going back to how it is in the regular U.S. health system.”

KHN correspondent Darius Tahir contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

Mayor’s Campaign to Eliminate Homelessness Attracts Federal Support

Mayor Karen Bass and Jeff Olivet representing President Joe Biden meet with government officials and service providers to combat homelessness. (Cora J. Fossett/L.A. Sentinel)


The Biden-Harris Administration is the latest entity to join Mayor Karen Bass’ efforts to assist the unhoused as Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness, announced the federal government’s support of the mayor’s initiatives.

At a press conference on Tuesday, Feb. 7, Bass, Olivet and service providers vowed to unite to address the connection between homelessness and substance abuse in hopes of reducing the numbers of people affected by both issues.  The group met at AADAP – Asian American Drug Abuse Program – in South L.A. to discuss the devastating impact of the two components.

“I’m very proud to be here at the Asian American Drug Abuse Program, an organization that’s been in our community for decades and that I have worked with personally for decades.  Today, we welcomed the second senior White House official to come to Los Angeles – Jeff Olivet representing President Biden – standing side-by-side, arm-in-arm, as we confront the crisis of 40,000 people living on the street,” said the mayor, who previously welcomed U.S. Housing and Urban Development Secretary Marcia Fudge to the city.

Dr. Va Lecia Adams Kellum of LASHA, left, participated in the meeting. (Cora J. Fossett/L.A. Sentinel)

A few weeks ago at a White House meeting, Bass urged Olivet to include L.A. in the administration’s goal to reduce homelessness in the nation by 25%.  Referring to L.A. as the “epicenter of that crisis,” Bass said that assisting Los Angeles would help make “a significant dent in achieving that goal.”

During his daylong visit, the mayor and Olivet toured homeless encampments on the L.A. Skid Row and stopped in on agencies helping unhoused individuals such as L.A. Community Action Network. Also, they traveled to 90th and Figueroa Streets where an Inside Safe program was introduced to replace a large encampment along the freeway off-ramp.

Inside Safe, a housing-focused initiative launched by Bass in December, is designed to permanently bring people inside from tents and encampments and prevent the encampments from returning.  City departments work closely with county agencies and service providers to obtain housing for homeless individuals and families.


Mayor Bass address the media during the press conference. (Andra Higgs/HUD)

“People are very thankful to be leaving the streets,” said Bass, who added that the unhoused individuals are temporarily residing in motel rooms, but will eventually live in permanent supportive housing.

“Oftentimes, it’s not just an issue of resources. As I have said all along, if we do not address substance abuse and mental health, we are kidding ourselves in our ability to end homelessness in Los Angeles,” insisted Bass.

“That is why we are at the Asian American Drug Abuse Program – because we wanted to highlight and emphasize the need to have substance abuse treatment as part of the continuum of care.  To address this problem, we need to have a complete alignment of every level of government – federal, state, county and the city,” she noted.

Expressing the federal government’s intention to collaborate with the mayor, Olivet said the Biden-Harris administration “set the 25% goal and we can’t get there without Los Angeles making serious progress so we’re very invested in your work.”

In another demonstration of the federal government’s backing in battling homelessness in L.A., HUD recently awarded $60 million in grants and vouchers to aid unsheltered people in the city and county of Los Angeles.

“The $60,000,000 award will support a range of permanent supportive housing options, new models of intensive case management services in partnership with health care providers, and rapid rehousing and crisis-response approaches for the most vulnerable in the community,” said HUD Region IX Regional Administrator Jason Pu, who also attended the Feb. 7 press conference.

Other participants in the meeting and press conference included Dr. Va Lecia Adams Kellum, newly appointed CEO of Los Angeles Homeless Services Authority (LASHA); Mercedes Marquez, chief of housing and homelessness in the Office of the Mayor; Maria Oliva, CEO of the National Alliance to End Homelessness; and Dean Nakanishi, CEO of AADAP.

Voters Will Determine Fate of Fast-Food Workers Pay Raise


February 09, 2023

By Edward Henderson

California Black Media


Last September, Gov. Gavin Newsom signed Assembly Bill (AB) 257 into law. Supporters of the legislation, authored by Assemblymember Chris Holden (D-Pasadena), hailed it for its promise to provide a minimum wage and improve working conditions for fast food workers.

But late last month, the future of AB 257 — also known as “the Fast Act” or “the Fast Food Recovery Act” — came into question. California Secretary of State Shirley N. Weber’s office announced that a referendum seeking to overturn the law had gathered enough signatures to be placed on the November ballot.

“To qualify for the ballot,” the Secretary of State’s office wrote, “the referendum needed 623,212 valid petition signatures, which is equal to five percent of the total votes cast for governor in the November 2018 General Election.

When AB 257 passed last year along party lines, it authorized the establishment of the Fast Food Accountability and Standards Recovery Act or FAST Recovery Act. The bill established the Fast Food Council within the Department of Industrial Relations, to be composed of 10 members to be appointed by the Governor, the Speaker of the Assembly, and the Senate Rules Committee.

According to the bill’s language, the purpose of the council is to establish “sector-wide minimum standards on wages (up to $22/hour in 2023 with capped annual increases), working hours, and other working conditions related to the health, safety, and welfare of, and supplying the necessary cost of proper living to, fast food restaurant workers, as well as effecting interagency coordination and prompt agency responses in this regard.” The act prohibits retaliation against fast-food workers for making certain workplace complaints.

Opponents of AB 257, led by a coalition called Save Local Restaurants, gathered more than 1 million signatures on a referendum petition. 712,000 of them were deemed to be valid by Weber’s office putting the referendum on the Nov. 5, 2024, ballot.

The Los Angeles Times published an article telling the stories of 14 voters who say they were misled by canvassers collecting signatures for the referendum. Many of them said that information was withheld from them about the nature of the campaign and were simply told it would support fast food workers.

But the laws’ opponents insist that their challenge to AB 257 is widely supported.

“California voters have made clear that they want a say on whether they must shoulder the burden of higher prices and job losses caused by the FAST Act,” said Save Local Restaurants in their press release. “This legislation singles out the quick service restaurant industry by establishing an unelected council to control labor policy, which would cause a sharp increase in food costs and push many Californians, particularly in disenfranchised communities, to the breaking point.”

The referendum means that the law is suspended until the November 2024 election when voters will decide whether to repeal it.

Holden, who is a former franchise owner said he believes AB 257 would protect both owners and employees – if those opposing the law allow it to work.

“Given, the final version of the bill removed many expressed concerns of subpoena power and joint-liability. While, strengthening the over-site role of the legislature, providing for equal Sector Council representation and adding a sunset clause to evaluate effectiveness.  As a result, this first in the nation worker protection bill is worthy to become law in California,” Holden said when Newsom signed the law last year.

Labor advocates believe the legislation could create a precedent in the U.S for negotiating workplace standards, which would, in turn, revolutionize the collective bargaining process.

However, the coalition of businesses opposing the law feel it would leave businesses with higher labor costs and hiked-up food prices.

According to the nonpartisan Fair Political Practices Commission, fast-food corporations and business trade groups including In-N-Out, Chipotle, Chick-Fil-A, McDonald’s, Starbucks and the National Restaurant Association donated millions to support the referendum effort.

“The FAST Act is bad policy that threatens not only quick service restaurants, but the independents operating in the same neighborhoods,” National Restaurant Association Executive Vice President for Public Affairs Sean Kennedy said in a press release. “There is no way that the regulations passed by this unelected council would not damage the state’s restaurant industry, harm its workforce, and leave diners paying the bill. We’re pleased that Californians will get the chance to exercise their constitutional right to vote on this law and will continue to support the operators, small business owners, and workers that make the restaurant industry so important to our customers’ lives.”