Biden administration developing plan to get Covid vaccines to the uninsured

The Biden administration plans to roll out a new initiative this week guaranteeing free Covid vaccines, treatments and tests for the uninsured into 2024, two people briefed on the matter told POLITICO.

The program comes as the White House prepares to wind down its pandemic response operation. It also represents an effort to ensure vulnerable Americans can still access shots and treatments once the government shifts broader responsibility for Covid care to the private sector.

Biden officials are preparing to begin that so-called commercialization process later this year. Under its forthcoming plan for the uninsured, the administration would keep a limited supply of vaccines, therapeutics and tests on hand to distribute free for months after the transition.

The people briefed on the matter cautioned that the plan’s specifics are not yet final and could still change. An HHS spokesperson did not immediately comment on the details of the program.

The administration, for example, has yet to finalize contracts with vaccine makers Moderna and Pfizer to purchase additional shots for the program. It is also still building out a distribution network to continue administering vaccines and treatments to the uninsured.

But HHS has set aside as much as $1.1 billion for the program, with the hope that it will keep Covid care free for uninsured adults through at least the summer of 2024, the people briefed on the matter said. Much of that money would go toward purchasing new vaccines in the fall, when drugmakers are expected to update their shots, and paying its distribution partners to administer them.

The stockpile for the uninsured will likely be small, given the lack of continued demand for the vaccine. Fewer than 40,000 people are now getting vaccinated per day as the pandemic recedes in people’s minds, according to the Centers for Disease Control and Prevention, the lowest rate since the Covid shots became widely available.

Officials have estimated they probably have enough of the antiviral Paxlovid on hand to cover future demand for the treatment from the uninsured.

The population that would qualify for free care would also be somewhat limited. There are about 30 million adults without health insurance, though that number could grow as pandemic-era protections expire and more people lose their Medicaid coverage. A separate, pre-existing federal program will continue providing free vaccinations for uninsured children.

Still, the program has taken on heightened importance within the administration amid scrutiny of its plans to hand off major responsibilities tied to a pandemic still killing more than 1,300 a week, according to the CDC.

Officials are particularly eager to avoid reports of low-income Americans going without Covid treatments because they can’t afford to pay out-of-pocket prices likely to reach hundreds of dollars per dose.

Top health officials, including CDC Director Rochelle Walensky and Assistant Secretary for Preparedness and Response Dawn O'Connell, are slated to appear Wednesday before Congress to discuss their priorities for the coming year.

Both Moderna and Pfizer are planning to charge at least $110 per dose for their vaccines on the private market, though they argue much of that cost will be covered for those who have insurance.

And while the companies have pledged to make the shots free for the uninsured through "patient assistance" programs, Biden officials remain skeptical they will be structured in a way that makes the vaccines easily accessible.

“We are going to have a plan to make sure that uninsured Americans continue to get access to vaccines and treatments for free,” White House Covid response coordinator Ashish Jha said in March on the “In the Bubble” podcast. “This is a really important goal, and we have set aside money to make sure we can meet that goal.”