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.

RELATED: Risk of developing diabetes after COVID-19 continued in Omicron period, Cedars Sinai study says

“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.

Karen Bass 1st Black Woman, 2nd Black Mayor of Los Angeles

U.S. Rep. Karen Bass will soon have a new title – “Madam Mayor.” (courtesy photo)

Los Angeles Sentinel Was The First News Outlet to Declare Historic Victory for Los Angeles First Female Mayor

U.S. Rep. Karen Bass will soon have a new title – “Madam Mayor.” With a lead of more than 5% that is continuing to grow, the longtime community advocate is pulling away from billionaire real estate developer Rick Caruso.

One week after election night where Caruso led by a very slim margin of less than 2%, Bass has not only surpassed Caruso, but has also enlarged the gap making the race virtually impossible for Caruso to overcome.

The results posted on Tuesday, Nov. 15, by the L.A. County Registrar-Recorder/County Clerk’s office marks the fifth update since election night that Bass has trended upwards to a point where it would be almost impossible for Caruso to overcome.

Representative Karen Bass now holds a 52.55% – 47.45% lead following Tuesday night’s update.  Bass has held a 60% – 40% margin or better over Caruso in every ballot count released since Thursday, November 10. Bass’ late surge is a repeat of the June 7 primary election where Caruso had a slight lead over the Congresswoman and several other candidates on election night, only to see that advantage disappear and Bass ending up the top vote getter, leading all challengers by 7% or more.

Rep. Karen Bass (File photo)

Rick Caruso spent an ‘extraordinary amount of money in an attempt to win the Los Angeles mayoral race with a budget exceeding $100,000,000, compared to Bass who raised and spent in the neighborhood of $9,000,000.

“In biblical terms, this was David vs. Goliath or Karen vs. Goliath.  The amount of money that Rick Caruso spent in an attempt to buy the mayor’s race was unprecedented, but the results of this election show that ‘Dollar Power’ cannot overcome ‘People Power,’ ” said Danny J. Bakewell, Sr., board chairman of the Los Angeles Brotherhood Crusade and executive publisher of the Los Angeles Sentinel and Bakewell Media.

Karen Bass is a longtime Democrat with years of political and community organizing experience.  Bass, who was the first African American woman ever elected Speaker of the California State Assembly, will now make history again as Los Angeles first female mayor and only the second African American mayor following in the footsteps of Tom Bradley, who defeated Sam Yorty for mayor in 1973.

While Rick Caruso is no newcomer to Los Angeles politics, previously serving as a Bradley appointee on the Los Angeles Water and Power Commission and later on the Los Angeles Police Commission, this is his first venture seeking an elected position.

“The citizens of Los Angeles saw through Rick Caruso’s claims to be a Democrat.  We all knew that he was a lifelong Trump-like Republican and only changed his voter registration in order to run for mayor,” noted Tracy Mitchell, president of Mothers in Action, a local nonprofit that provides numerous resources to the residents of the South Los Angeles community.

The lead in the vote totals changed hands three times in the hours immediately after the polls closed on Nov. 8, with Caruso holding a 2.5-point lead on Wednesday, Nov. 9. But since then, every new release of voting information from county officials has favored Bass, with the congresswoman taking the lead on Friday, Nov. 11.

Unlike in years past, or pre-COVID, where votes were generally counted in precincts and pundits could forecast outcomes based upon a candidates popularity in one area over the other, now we are in a post-COVID environment.  In post-COVID times and with mail-in ballots becoming the norm throughout California, the late ballot vote counts come from a broad array of areas, demonstrating that Bass popularity is citywide instead of in a distinct part of the area such as her congressional district in South Los Angeles.

This fact means that there is no reason to expect that any batch of ballots will be largely different from the previous voting trends, which have been coming in for over a week.  At this point, the likelihood that Rick Caruso could reverse a week’s worth of election trends is virtually impossible and he could only win with an astounding reversal of the current voting trends, which appears to be highly unlikely.

As the votes are counted, most campaigns await a news agency to call the election and the victory.  Given the continuous voting trends and the virtually mathematical impossibility of a Caruso victory, the Los Angeles Sentinel is proud to proclaim Karen Bass as the winner and Mayor of the city of Los Angeles!

Karen Bass is currently in Washington D.C., fulfilling her role as the Congressional Representative for District 37, (that is, until Sydney Kamlager-Dove, who was currently leads Jan Perry in a race to succeed Bass in Congress, assumes that spot). Rep. Bass stated, “I am honored and grateful for the support we are continuing to see. I am optimistic and looking forward to the next update.”

The Caruso campaign has yet to release a statement concerning the continuous slide, falling further and further behind.  But earlier ton Tuesday, Nov. 15, the Caruso campaign did email out a letter to “supporters” thanking them for their backing and encouraging voters to track their ballots and insinuating that there were possible missed signatures and/or mismatch signatures on the ballots, in hopes of somehow reversing the trend of falling further and further behind.

 

Biden calls for resignation of LA city council members over racist remarks

Nury Martinez attends Women’s March Action: March 4 Reproductive Rights at Pershing Square on Oct. 2, 2021 in Los Angeles.

Amy Sussman/Getty Images

“Unacceptable” and “appalling” is how White House Press Secretary Karine Jean-Pierre described the crude and disparaging racist remarks that surfaced this week in a recording of three city council members in Los Angeles. President Biden believes all three council members should give up their seats, Jean-Pierre said. The recording was first reported by the Los Angeles Times on Sunday.

On Tuesday, Councilwoman Nury Martinez announced that she intends to take a leave of absence, but she stopped short of submitting her resignation. Martinez employed racist and derogatory language to describe the son – who is black – of another council member, using a Spanish term meaning “little monkey” and stating that the boy needed “a beatdown.” In addition, she described Oaxacan immigrants in Koreatown as “short little dark people.” Council members Gil Cedillo and Kevin de León also participated in the conversation.

All three council members have issued apologies.

The president’s statement comes as he embarks on a West Coast tour where he is scheduled for several public events, including a fundraiser with Democratic Congresswoman Nancy Pelosi. He joined high-ranking California officials in his call for the council members’ resignations. Scores of outraged protesters interrupted a city council meeting on Tuesday.

The White House used the occasion to excoriate Republicans for their treatment of incidents of racism within their own party.

“Here’s the difference between Democrats and Republicans: When a Democrat says something racist or antisemitic … we hold Democrats accountable,” said Jean-Pierre. “When a MAGA Republican says something racist and or antisemitic, they are embraced by cheering crowds and become celebrated and sought after.”

Councilman Mike Bonin — whose son was the subject of the derogatory remarks — gave an emotional statement on Tuesday. “I take a lot of hits, but my son?” said Bonin. He called his fellow council members’ comments unforgivable.

Report Reveals ‘A Hidden Key to Combating Racial and Ethnic Disparities in Juvenile Justice’

Report Reveals ‘A Hidden Key to Combating Racial and Ethnic Disparities in Juvenile Justice’

Stacy Brown / NNPA Newswire 

According to new Sentencing Project research, diverting youth from juvenile court involvement should be a central focus in reducing racial and ethnic disparities.

It should also improve outcomes in America’s youth justice systems.

The report’s author wrote that getting arrested in adolescence or having a delinquency case filed in juvenile court clearly damages young people’s futures and increases their subsequent involvement in the justice system.

“Compared with youth who are diverted, youth who are arrested and formally petitioned in court have a far higher likelihood of subsequent arrests and school failure,” wrote Richard A Mendel, Senior Research Fellow and Youth Justice at the Sentencing Project.

“Pre-arrest and pre-court diversion can avert these bad outcomes,” Mendel concluded.

According to Mendel’s research, Black youth are far more likely to be arrested than their white peers and far less likely to be diverted from court following arrest.

Other youth of color – including Latinx youth, Tribal youth, and Asian/Pacific Islander youth – are also less likely than their white peers to be diverted.

“The lack of diversion opportunities for youth of color is pivotal because the greater likelihood of formal processing in court means that youth of color accumulate longer court histories, leading to harsher consequences for any subsequent arrest,” Mendel asserted.

“Expanding diversion opportunities for youth of color, therefore, represents a crucial, untapped opportunity to address continuing disproportionality in juvenile justice,” he noted.

The in-depth analysis of the juvenile justice system’s unequal and limited use of diversion from court involvement, particularly for Black youth, found that in 2019, 52% of delinquency cases involving white youth were handled informally (diverted), far higher than the share of cases diverted involving Black youth (40%).

The report found the glaring disparity between Black and white youth in every major offense category.

“Overwhelming research finds that diverting youth from the court system yields better outcomes for young people’s futures and public safety,” Mendel insisted.

“Yet diversion remains sorely underutilized, especially for youth of color, and unequal treatment in diversion is a key driver for even larger disparities in confinement later in the process.”

Released on Aug. 30, the report, “Diversion: A Hidden Key to Combating Racial and Ethnic Disparities in Juvenile Justice,” examined decades of research showing how educational, career and public safety outcomes are better for youth diverted away from juvenile courts.

It provided a primer on diversion and its impact on racial equity – specifically, the report revealed that:

  • Compared to youth formally involved in court, youth diverted from court have a far lower likelihood of subsequent arrest.
  • They also are far less likely to be incarcerated, commit less violence, have higher school completion rates and college enrollment, and earn higher incomes in adulthood.

Mendel found that disparities in diversion result both from subjective biases against youth and families of color and from seemingly neutral diversion rules and practices that cause disproportionate harm to youth of color either by unnecessarily limiting eligibility for diversion or by making it difficult for youth of color to complete diversion successfully.

Many states and localities have recently adopted new strategies to expand and improve diversion, many of which show substantial promise, Mendel further discovered.

“However, efforts to expand diversion opportunities to date have most often lacked an explicit and determined focus on reducing racial and ethnic disparities – an essential ingredient for success,” he added.

In his conclusion, Mendel said the evidence leaves no doubt that the justice system “is toxic for youth and should be employed only in cases when young people pose a serious and imminent threat to the safety and well-being of others.”

“For most young people, diversion yields better public safety and youth development outcomes than formal processing in juvenile court – and for much less money,” he wrote.

However, youth of color are not being offered diversion in the same numbers as white youth.

“Racial and ethnic disparities at diversion play a significant role in propelling system-wide disparities and represent a key reason why efforts to improve equity in juvenile justice have achieved so little progress to date,” Mendel added.

For all these reasons, the diversion stage of the juvenile court process should be a top priority for youth justice reform, he stated.

“Advocates should push for, and system leaders should take aggressive action to address the disparities highlighted in this report,” Mendel wrote.

“Combined, the reforms recommended here to expand the use of diversion and to enhance supportive community-led programming for diverted youth offer perhaps the most important and promising avenue currently available to reduce disparities and to improve youth justice systems nationwide.”

August is National Minority Donor Awareness Month

August is National Minority Donor Awareness Month, which focuses attention on the need for minority blood and organ donors. The focus of the awareness campaign is to increase participation in donor programs in order to save lives.  According to the U.S. Department of Health & Human Services, communities of color have much higher rates of high blood pressure, diabetes, obesity, and heart disease, all of which increase the risk for kidney disease. Black Americans are almost four times more likely, and Latino Americans are 1.3 times more likely, to have kidney failure compared to White Americans. Despite the higher risk, data shows Black and Latino patients on dialysis are less likely to be placed on the transplant waitlist and have a lower likelihood of transplantation. 

As of 2021, the organ with the most patients waiting for transplants in the U.S. was kidneys, followed by livers. Over 100 thousand patients were in need of a kidney at that time. Within the African-American, Asian, Hispanic, Native American, and Pacific Islander-American communities, the need for transplants becomes even more dire. Minorities make up 57% of those on the organ waiting list. Due to chronic conditions, minority patients see an increased need for transplants affecting the heart, kidney, pancreas, and liver.

Bone Marrow
Because only about 30% of patients can find a fully matched donor within their family, most people in need of a bone marrow transplant are matched through the registry. Yet despite its large size, this volunteer registry lacks ethnic and racial diversity. For example, a Black person has a 29% chance of finding a matched donor in the registry, while a white person has a 77% chance. People who are American Indian and Alaska Native have a 57% chance of finding a registry match, Asian and Pacific Islander patients at 47%, and Hispanic or Latino patients at 48%. People of color make up a small percentage of all donors, making it difficult to find matches for people with cancer who are not white or who are of mixed race and ethnicity.

Organ Transplant
African Americans make up the largest group of minorities in need of an organ transplant. In 2019, blacks made up 12.8 percent of the national population. Thirty-eight percent of African Americans stated they would not donate organs, compared to 10% of whites. When asked why not, African Americans stated “personal reasons” followed by “if I am an organ donor, I won’t get the necessary medical attention” as their top choices. Although many black and Asian patients can receive a transplant from non-minority donors, for many, the best match will come from a donor from the same ethnic background.

It is important to note that organ donation is not based on race or ethnicity. Anyone can donate because all organs can save a life. And while the race of blood donors and blood recipients typically do not matter as long as their blood types are compatible, individuals who are Black (including African American or other individuals of African descent) can have unique needs.

Sickle Cell Blood Needs
Black patients continue to face racial inequities in the fight against sickle cell disease. Unlike other diseases, there have been fewer health resources available to help those suffering from sickle cell disease in comparison to similar diseases. Today, blood transfusions for patients with sickle cell disease remain one of the primary treatments to help alleviate the pain of this disease. Blood transfused to patients with rare blood types, like those with sickle cell disease, must be matched very closely to reduce the risk of complications. These patients are more likely to find a compatible blood match from a blood donor of the same race or ethnicity.

New initiative to make UC Davis Health a leader in organ transplant equity

Call To Action
Part of being informed includes us practicing good health habits. Get regular exercise, and increase fruits and vegetables in your diet. Limit saturated and trans fats, sodium, and added sugars and control portion sizes. The healthier we are, the fewer transplants will be needed.

Living donation does not change life expectancy and does not appear to increase the risk of kidney failure. In general, most people with a single normal kidney have few or no problems. Help us spread the word about the importance of minority blood and organ donation.

  1. Learn more about organ donation. Donate Life
  2. Hashtag It–#NationalMinorityDonorAwarenessDay
    Share this post on your social media platform to help increase awareness about this issue impacting our people.
  3. Share your story

If you’re a donor or a recipient, share your success story to encourage others to become donors.

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