Senator Calls on Senate, House Leaders to Prioritize Effort in Next COVID-19 Relief Package

WASHINGTON, D.C. [03/4/21]—U.S. Senator Tina Smith (D-Minn.) continued her fight to protect all Americans, regardless of their insurance status, from out-of-pocket charges for their coronavirus (COVID-19) vaccine by urging Senate and House leaders to prioritize this effort while negotiating the next COVID-19 relief package.

 In a letter to Senate Majority Leader Chuck Schumer, Speaker of the House Nancy Pelosi, Senate Minority Leader Mitch McConnell and House Minority Leader Kevin McCarthy, Sen. Smith said that eliminating cost barriers is necessary to deliver vaccines as equitably as possible and prevent further exacerbating health disparities. 

  “Ever since the launch of Operation Warp Speed (OWS), a public-private partnership with a mission to accelerate the development, manufacture, and efficient distribution of COVID-19 vaccines and therapeutics, I have been concerned about out-of-pocket vaccine costs for individuals who are uninsured or underinsured, individuals who far too often fall through the cracks,” said Sen. Smith. “Americans without insurance are more likely to forgo medical care for chronic conditions or preventive care, and they are more likely to report problems paying their medical bills when they do seek care. In addition, communities of color are more likely to be uninsured.  Latinos are nearly three times as likely to be uninsured compared with their white counterparts, and Black Americans experience a higher uninsured rate than white Americans. It is imperative that we address the cost barriers of the uninsured and underinsured at the beginning of COVID-19 vaccine distribution to avoid further exacerbation of health disparities.”

In August 2020, Sen. Smith introduced legislation to make COVID-19 vaccines free to everyone, regardless of insurance status. The Free COVID-19 Treatment Act would waive any cost-sharing for COVID-19 treatment and the COVID-19 vaccine for everyone, regardless of how an individual gets health insurance, or whether they have insurance at all.

 You can read the letter here or below.

March 3, 2021

The Honorable Charles Schumer                    The Honorable Mitch McConnell

Majority Leader                                              Minority Leader

United States Senate                                       United States Senate

Washington, DC 20510                                  Washington, DC 20510

 

The Honorable Nancy Pelosi                          The Honorable Kevin McCarthy

Speaker                                                           Minority Leader

United States House of Representatives         United States House of Representatives

Washington, DC 20515                                  Washington, DC 20515

 

Dear Majority Leader Schumer, Minority Leader McConnell, Speaker Pelosi, and Leader McCarthy,

Thank you for your ongoing work to negotiate a COVID-19 recovery package, which is urgently needed to address the public health and economic crisis caused by COVID-19.  As you work to finalize the next COVID-19 relief bill, I want to thank you for including provisions that will protect all Americans, regardless of insurance status, from out-of-pocket charges for their COVID-19 vaccine, and I hope these will be included in the final COVID-19 recovery package.    

 

Ever since the launch of Operation Warp Speed (OWS), a public-private partnership with a mission to accelerate the development, manufacture, and efficient distribution of COVID-19 vaccines and therapeutics, I have been concerned about out-of-pocket vaccine costs for individuals who are uninsured or underinsured, individuals who far too often fall through the cracks.  Americans without insurance are more likely to forgo medical care for chronic conditions or preventive care, and they are more likely to report problems paying their medical bills when they do seek care.[3]  In addition, communities of color are more likely to be uninsured.  Latinos are nearly three times as likely to be uninsured compared with their white counterparts, and Black Americans experience a higher uninsured rate than white Americans.[4]  It is imperative that we address the cost barriers of the uninsured and underinsured at the beginning of COVID-19 vaccine distribution to avoid further exacerbation of health disparities. 

 After several inquiries to the Trump Administration on this topic, I was informed that all COVID-19 vaccines purchased by the federal government will be provided at no cost to taxpayers.  However, despite these promises and federal rulemaking to clarify this point, Minnesota still sought federal funding to cover the cost of administering the vaccine for uninsured and underinsured Minnesotans.  

 A legislative solution was necessary, so I introduced the COVID-19 Treatment Coverage Act, which would require Medicaid to cover and prohibit cost sharing for COVID-19 vaccines, guaranteeing that no one on Medicaid would be denied access to a potentially lifesaving vaccine during the pandemic.  My bill would also provide States with the option and financial incentive to expand Medicaid in order to cover the vaccine for uninsured individuals.  I have been pushing to get these provisions included in a COVID-19 relief package, and I was assured to see progress with the House American Rescue Plan.

 The House American Rescue Plan includes several provisions that are critical for protecting Medicaid beneficiaries and the uninsured from charges for their COVID-19 vaccines.  Specifically, the bill requires State Medicaid plans, including limited Medicaid benefit plans, to cover COVID-19 vaccines and treatment without cost sharing, and it provides a federal medical assistance percentage (FMAP) of 100 percent for this purpose.  This provides States with the financial security of receiving full reimbursement for covering COVID-19 vaccine and treatment costs of their most vulnerable citizens at a time when their budgets have been stressed due to the financial pressures of the pandemic.

In addition, the House package includes critical provisions to protect the uninsured.  It provides states with the option and financial incentive to expand their Medicaid programs in order to cover COVID-19 vaccines and treatment for the uninsured without cost sharing through a 100 percent FMAP.  In combination with other House reconciliation proposals, the bill provides new coverage options for the uninsured, including additional financial assistance to enroll in health insurance coverage through the Affordable Care Act’s (ACA’s) individual market, COBRA premium assistance to maintain access to employer sponsored insurance, and additional incentives for States to pursue a comprehensive expansion of their Medicaid programs. These measures take important steps to guarantee that Americans who have experienced pandemic-related health insurance loss or were already uninsured because of a lack of affordable coverage will have several options to protect themselves from out-of-pocket COVID-19 vaccine costs. 

These provisions are necessary to protect all individuals, regardless of insurance status, from charges for their COVID-19 vaccine, and I am grateful for your leadership in including these provisions in the House American Rescue Plan.  I am hopeful they will make it into the final reconciliation package.  In addition, I hope you will work to ensure that there is sufficient funding in the Health Resources and Services Administration (HRSA) COVID-19 Uninsured Program to reimburse providers for COVID-19 vaccination administration fees for uninsured individuals whose expenses are not covered through other options. 

 Thank you again for your work to fulfill our responsibility and commitment to deliver the COVID-19 vaccine to the American people as efficiently and equitably as possible. 

Sincerely,

 


[1] Tolbert, J., Orgera, K., & Damico, A. (2020, November 6). Key Facts about the Uninsured Population. Kaiser Family Foundation. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

[2] Cohen, R.A., Cha, A.E, Martinez, M.E., & Terlizzi, E.P. (2020, September). Health Insurance Coverage: Early Release of Estimates from The National Health Interview Survey, 2019. National Center for Health Statistics. https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202009-508.pdf

[3] Tolbert, J., Orgera, K., & Damico, A. (2020, November 6). Key Facts about the Uninsured Population. Kaiser Family Foundation. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

[4] Cohen, R.A., Cha, A.E, Martinez, M.E., & Terlizzi, E.P. (2020, September). Health Insurance Coverage: Early Release of Estimates from The National Health Interview Survey, 2019. National Center for Health Statistics. https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202009-508.pdf

Issues