Struggling Launch of Latest COVID Vaccine Campaign: Challenges and Progress

The launch of the newly approved COVID-19 vaccines, the first campaign since the federal pandemic emergency ended, is encountering some challenges. 

Reports are surfacing of insured Americans being unexpectedly charged almost $200 for the shots, despite their recent approval. These new vaccines were developed to safeguard against new strains of the coronavirus and are recommended for all individuals over the age of 6 months. 

While the Biden administration is working to make the vaccines accessible to uninsured Americans, it remains uncertain if the current supply will meet the demand. 

According to news reports and social media complaints, not all insured individuals are receiving the COVID vaccines free of charge. Insurers are still updating their plans to cover the shots due to new billing codes introduced for these vaccines. However, major health insurance providers like Blue Cross Blue Shield, Aetna, and Kaiser Permanente have stated that they will cover the COVID-19 shots as routine vaccinations. Cigna and Anthem did not respond to comments or redirected inquiries to AHIP, the health insurance trade association.

“Health insurance providers are collaborating with the federal government, pharmacies, and healthcare providers to ensure that everyone has access to ACIP-recommended vaccines without cost sharing,” AHIP stated in response to the issue, as reported by The Hill.

“The new vaccine formulations mark the first time that the COVID-19 vaccines are available without being purchased or distributed by the federal government.”

Health and Human Services Secretary Xavier Becerra received his updated COVID shot at a CVS Pharmacy in Washington to promote vaccine uptake and the availability of vaccines at pharmacies. 

Addressing concerns about insured individuals having to pay out-of-pocket, Becerra reassured the public that their claims of insurers not covering the shots are inaccurate.

“Please make sure you’re talking to your insurance company because. You should be covered by law. If you are insured, you are covered for COVID. If you are on Medicare, you are covered. If you are on Medicaid, you are covered and if you don’t have insurance — through this Bridge Access program — you are covered,” Becerra stated.

He also advised insured customers to consult with their pharmacists to resolve any confusion surrounding coverage.

“We’ve contacted the insurers and contacted the pharmacists, and we’re working with them to make sure everyone understands how this works,” Becerra added.

For uninsured individuals, the Biden administration has rapidly expanded various pathways to deliver COVID-19 vaccinations. The initiative, known as the Bridge Access Program, will distribute vaccines through community health centers, local health departments, and pharmacies. 

Initial concerns about delayed contracts with pharmacies participating in the Bridge program, including CVS, Walgreens, and eTrueNorth, have been assuaged. The CDC announced that existing contracts have been modified to offer shots in areas with low coverage and access.

The HHS estimates that over 20,000 retail pharmacy locations across the U.S. will provide no-cost vaccinations through the Bridge program until December 2024.

However, community health centers and local health departments are now adjusting to a COVID response without the federal funds they previously received to aid in administering doses.

According to Lori Freeman, CEO of the National Association of County and City Health Officials (NACCHO), health centers are lacking both the resources and supplies they previously relied on.

“There will be about 6 million vaccines available, and those initial vaccines are targeted towards the uninsured and underinsured individuals through what is called the Bridge Program,” Freeman explained.

“Three million doses will be available to state and local health departments through federally qualified health centers and regional community health centers. Considering that there are approximately 25 million uninsured people in the country right now, you can easily do the math.”

Health stakeholders remain uncertain about the level of demand they should expect for the shots. However, Freeman noted that member departments within her organization have been receiving an increasing number of phone calls about obtaining a vaccine since the CDC approved them.

HHS has not disclosed the quantity of vaccines that will be made available through the Bridge program, and Becerra did not provide a specific figure when questioned about it.

“This is a billion-plus dollar program. As I said, you don’t have to pay out of pocket for your vaccine, but it is not cost-free. There are costs to making a vaccine available,” he clarified.

According to Freeman, many health departments may struggle to cover the costs of these newer vaccine formulations, even with reimbursements.

“Some of the challenges we’re seeing specifically with the involvement of local health departments are billing issues, where the reimbursement available to them is less than the cost of the vaccine,” Freeman highlighted.

She revealed that she has been told about a reimbursement rate of $65 for every $120 dose.

Freeman added that not all the doses allocated for the Bridge program will be immediately available. As a result, health departments in areas with a high number of uninsured individuals may face a shortage of supply while manufacturers and distributors work on delivering the medicine.

Nonetheless, Becerra expressed confidence in vaccine access and reassured the public that these initial challenges will be quickly addressed.

“We’ve been working with insurers and pharmacists for months. We had to reach contracts with various stakeholders. So, everyone has been aware, but sometimes, whether it’s a computer glitch or something else, obstacles can arise,” he stated. “I believe these are setbacks that will be resolved swiftly.”

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