#Horizon landscape supply for free
While COVID-19 vaccines, including boosters, will continue to be available for free to virtually all those with public and private insurance even when there is no longer any federally-purchased supply remaining or PHE protections in place, this will not be the case for COVID-19 treatments and tests, where cost sharing will be widely permitted. The extent of these challenges varies by product and is most acute for treatments and tests.While each of these two changes – the depletion of the federal supply and end of the PHE – matters on its own, their interaction also matters and may amplify access challenges.4 Overall, the key findings are as follows: This document provides an overview of these anticipated changes and their implications for access to COVID-19 vaccines (including boosters), treatments, and testing by payer. Depending on the type of product (vaccines/boosters, treatments, or tests) and insurance coverage (Medicare, Medicaid/CHIP, private, or uninsured/underinsured), access problems could come in the form of new or higher cost sharing, more limited coverage, or both. Taken together, these two changes could act as a “double whammy” of sorts, curtailing access to COVID-19 countermeasures. At that time, the protections put in place by Congress and the administration that are tied to the PHE will either end right away or, in some cases, at specified periods after this date. 3Although the § 319 PHE declaration has been renewed every 90 days since first declared, the administration announced that it would end the PHE on May 11, 2023. It is also uncertain how many vaccines local pharmacies may purchase, particularly in areas with low demand. Additionally, without the federal government’s guaranteed “market” for these products through their advance purchase, it is uncertain whether manufacturers will have an incentive to produce sufficient quantities, including, for example, during future COVID-19 surges or for new and updated vaccines. For example, without a federally-purchased supply, consumers may face cost sharing. This could affect access in multiple ways. It is widely expected that once the current federally-purchased supply is depleted, these products will transition to the commercial market for their manufacturing, procurement and pricing.
While the administration has said that it will need additional funding if more products are to be procured and provided for free (and has asked Congress for approximately $9.1 billion as part of a supplemental emergency funding request), Congress has yet to provide any. The Depletion of Federally-Purchased Supply.
Two changes on the horizon, however, will affect this landscape and, ultimately, access to, pricing, and coverage of COVID-19 medical countermeasures: The effective dates of many, though not all, of these requirements are tied to the public health emergency (PHE) declaration made pursuant to Section 319 of the Public Health Service Act, first declared in January of 2020 and renewed every 90 days since, including most recently on February 9, 2023. In addition, Congress enacted several bills 1 that included special requirements for their coverage by both public and private insurers, and the administration issued guidance 2 and regulations to protect patient access and promote equitable distribution. In response to the unprecedented nature of the COVID-19 pandemic, the federal government spent billions of dollars in emergency funds to purchase medical countermeasures – vaccines, including boosters, treatments, and tests – to provide them free of charge to the public. Editor’s Note: This brief was updated on Feb.13, 2023 to reflect the date on which the public health emergency will end, as announced by administration.
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