A lack of renewed funding could impact everything from booster shots to research into future variants.
Over the course of the COVID-19 pandemic, there have been many resources readily available to the general public: free COVID-19 tests, free COVID-19 vaccines, and free COVID-19 boosters, regardless of a person’s health insurance status.
Now, some aspects of America’s COVID response are in jeopardy, because Congress did not renew critical funding in the ballpark estimate of $22.5 billion, which was requested by the Biden Administration earlier this month.
Brookie Crawford, a public information officer for the Virginia Department of Health’s (VDH) Central Region, spoke to Dogwood about what the lack of funding could mean for the commonwealth.
“Our understanding is [that] this will cause providers to no longer be able to submit claims to the federal Uninsured Program for Testing, Treating, and Vaccine Administration. This change could disincentivize providers from providing these services to uninsured persons. This could increase burden on some patients and could strain the public health safety net. This change could result in inequities related to access to these types of prevention and care. This change may also leave patients with COVID-19 with no practical option to get medical care other than an emergency department where the patient must be seen,” Crawford said. “There could be downstream effects of this change, such as some patients progressing to more severe illness or more disease spread.”
On March 23, the White House COVID-19 Response Team, along with public health officials, held a press conference centered around the ongoing pandemic. There, Xavier Becerra, Secretary of the Department of Health and Human Services, and Jeff Zients, White House Coronavirus Response Coordinator, doubled down on the impact the lack of renewed funding could have on the country.
The effects are already taking place, and here’s what’s already happened:
- The fund Congress established to reimburse doctors and other medical providers for COVID care for uninsured Americans stopped accepting new provider claims for testing and treatment services on March 22
- The US canceled a purchase of additional monoclonal antibody treatments scheduled for March 25
- State shipments of monoclonal antibody treatments reduced by 35% as of March 23
On April 5, the Health Resources and Services Administration (HRSA) COVID-19 Coverage Assistance Fund will stop accepting new claims for vaccination services “due to a lack of sufficient funds,” according to the agency’s website. That means healthcare providers who grant those services to their patients will no longer receive reimbursement payments for those actions through the fund.
In addition, with the current lack of funding preventing purchases of the monoclonal antibody treatments, the national supply could start to run out by late May, President Joe Biden announced on March 30.
As far as booster shots go, there are enough doses for the springtime, both for the immunocompromised and for the recently authorized 50+ population that Biden noted in his most recent update. However, if boosters are needed for the general population in the fall, the lack of renewed funding could prevent them from being available, free, and easy to access, the president warned.
“Not having enough vaccines is completely unacceptable, as vaccines have proven to be our single most important tool in protecting Americans,” Zients said. “We should be securing additional supply right now.”
At the March 23 press conference, Dr. Rochelle Walensky, Director of the Centers for Disease Control and Prevention (CDC), expressed that the agency is closely tracking the BA.2 sublineage of the Omicron variant.
She noted that the variant has been in the United States for about two months, and it has been slowly increasing in proportion compared to the BA.1 Omicron variant that circulated through the nation in the winter. The BA.2 variant has increased transmission, compared to BA.1.
“This week, we estimate that BA.2 represents about 35% of circulating variants nationally,” Walensky said at the time, though it accounted for over 54% of the circulating variants by March 29. “As we’re learning from our colleagues in Europe, Asia, and South Africa, where BA.2 has resulted in varied peaks of cases, there’s no evidence that BA.2 variant results in more severe disease, nor does it appear to be more likely to evade our immune protection.”
Just because BA.2 isn’t more severe than other variants doesn’t mean the US can let its guard down against the health threat. Walensky expressed a critical need to continue to provide people with the tools to keep them, their families, and their communities safe.
“I’d like to emphasize that if cases rise from the Omicron variant or any other variant, we have the tools, vaccines, boosters, tests, and therapeutics to be prepared,” she said. “But continued investment in these tools so that they are readily available when we need them remains critical.”
Where Does That Leave Us?
Zients also spoke about the BA.2 risks associated with a cutoff of funding at the press conference.
“If we maintain our preparedness, an increase in cases does not need to be a cause for alarm like it once was. We know what tools we need to fight the virus. Unfortunately, because of congressional action, we’re at risk of not having these tools readily available,” Zients said. “This should be unacceptable to every American. For months, we’ve made clear to Congress, on a bipartisan basis, that funding for core COVID medical supplies—including vaccines, treatments, and tests—was running out. Congress has failed to act. They failed to provide the necessary funding, and we’re already seeing the consequences.”
Becerra noted that President Joe Biden’s COVID-19 Preparedness Plan builds on America’s pandemic response efforts to move forward safely, but that the pandemic response efforts would require continued support from Congress to remain effective.
“To summarize the consequences of congressional inaction are severe and they are immediate: the uninsured fund is winding down, fewer lifesaving monoclonal treatments are being sent to states, fewer treatments available for the immunocompromised, and we risk not having sufficient vaccine supply or testing capacity,” Zients said. “These consequences will only get more significant over time, with less treatments, vaccines, and tests for the American people.”
In Virginia, Crawford expressed that VDH will remain on top of the issue, but noted the potential for challenges.
“VDH is gathering information to assess the potential scope of this issue, and is anticipating more detail from federal partners. VDH is considering how we may need to adjust our program planning to ensure access to testing, vaccines, and treatment for Virginians, regardless of insurance status,” Crawford said. “It is possible that we may not be able to sustain testing or treatment capacity or be appropriately prepared for future surges if funding does not come through this federal package.”
As of March 28, the Biden Administration released more specifics on pandemic preparedness and biodefense initiatives included in the FY 2023 President’s Budget, a historic $88.2 billion request.
The funds would:
- Transform the county’s capability to rapidly produce and deliver countermeasures against pandemics and other biological threats
- Strengthen America’s public health infrastructure and early warning capabilities
- Invest in basic research to enable an effective response to novel pandemics and biological threats
- Modernize and streamline America’s regulatory infrastructure
- Advance biosafety and biosecurity in the United States and globally to prevent biological incidents
- Transform global health security and pandemic preparedness for COVID-19 variants and future biological threats
If Congress doesn’t act quickly, portions of the funding responsibility could fall on individual providers. According to the HSRA, “per the Centers for Disease Control and Prevention’s Requirements for COVID-19 Vaccination Program Providers, providers must continue to administer COVID-19 vaccines at no out-of-pocket cost to recipients.”
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