SACRAMENTO, Calif. — California remains to be providing free covid testing to uninsured residents despite the fact that the federal authorities ran out of cash to pay for it.
Whereas Congress debates whether or not to place extra money into free testing, California is leaning on packages it already had in place: particular state-based protection for uninsured Californians, faculty testing, and free checks provided by clinics, counties, and different teams. Absent free choices, individuals with out medical health insurance might pay as a lot as a number of hundred {dollars} out-of-pocket relying on the place they get examined.
On the similar time, demand for neighborhood testing — from residents with and with out insurance coverage — has dropped precipitously.
On a current Thursday, solely three individuals may very well be discovered getting examined at seven testing websites in Sacramento County. Staffers at these areas — from the previously bustling mass-testing website on the state fairgrounds to a tiny kiosk in a church parking zone — mentioned hardly anybody reveals up anymore despite the fact that testing remains to be necessary for monitoring and decreasing the unfold of covid-19. They largely see regulars who are available for routine testing required by their employer or faculty.
Dr. Olivia Kasirye, the general public well being officer for Sacramento County, mentioned the county sends specimens to a state lab without charge to the county, which has helped hold free testing providers up and working. California is quietly ending its contract with a central lab, however the state says it should shift testing to a community of business labs. State officers instructed KHN there will likely be no modifications for sufferers.
“I feel we are able to preserve providers” for now, however the future is unsure, Kasirye mentioned.
Because the starting of the pandemic, the federal authorities had reimbursed suppliers for testing, treating, and vaccinating uninsured individuals for covid-19. However the Well being Assets and Companies Administration stopped accepting reimbursement claims for checks and coverings March 22, and for vaccinations April 5, saying the cash had run out. The federal government had been reimbursing suppliers $36 to $143 per take a look at.
Since then, states and counties have been watching their case charges and coffers to see whether or not they can hold testing uninsured residents.
In Alabama, Dr. Scott Harris, the state well being officer, mentioned providing free testing to individuals 5 days per week via county well being departments is “in all probability not one thing we’re going to have the ability to maintain for much longer,” particularly in pockets of the state with giant uninsured populations.
“We’re going to have zero providers for these individuals,” Harris mentioned. “And no capacity to incentivize suppliers to see them.”
Congress returns from recess in late April however might not renew this system. Lawmakers beforehand thought-about extending it however selected to not embrace cash for it in a $10 billion covid funding deal that’s been pending since early April.
The Covid-19 Uninsured Group
Well being care advocates say California has been in a position to proceed free testing for the uninsured, together with for residents with out authorized documentation, due to the way it used a separate pot of federal funding. Though 15 different states additionally leveraged pandemic help, advocates imagine California expanded advantages probably the most.
In August 2020, California created an insurance coverage program with pandemic aid cash to cowl covid-related therapies, testing, and vaccines for uninsured individuals or these whose insurance coverage don’t cowl these providers. The Covid-19 Uninsured Group basically acts as Medicaid for covid, however with no earnings necessities. That’s totally different from conventional Medi-Cal, California’s Medicaid program, which is for low-income individuals.
Protection will finish when the federal public well being emergency does. On April 13, the U.S. Division of Well being and Human Companies renewed the emergency declaration for 90 days, extending it to mid-July.
The state program is a intelligent method to make use of federal {dollars}, mentioned David Kane, a senior lawyer on the Western Heart on Legislation & Poverty. However he famous there are drawbacks. Individuals have to be enrolled earlier than they’ll get hold of providers, they usually can’t enroll themselves. Solely sure well being care suppliers, largely hospitals and clinics, can signal individuals up.
“This system was by no means designed to exist in isolation,” Kane mentioned, “however now it does.”
About 291,000 individuals had been enrolled in this system as of April 4, in keeping with Anthony Cava, a spokesperson for the state Division of Well being Care Companies, which administers Medi-Cal. An estimated 3.2 million Californians, or round 9.5% of individuals youthful than 65, are uninsured.
Kane urged that folks discover a certified supplier from a database maintained by the Division of Well being Care Companies or by calling the Medi-Nurse line and get enrolled as quickly as attainable, particularly if they’re used to strolling as much as a testing website and paying nothing.
The problem is getting individuals to enroll earlier than they get sick or want a take a look at, Kane mentioned, and holding this system going with the added affected person load.
Screening College students
One other main supply of free testing in California is public colleges.
California distributed greater than 14.3 million at-home checks to varsities earlier than college students left for spring break. The faculties in flip handed out the fast checks to households to allow them to display college students earlier than sending them again to campus. The state had an identical program for the winter holidays.
The winter testing was “extremely efficient,” in keeping with Major Well being, the corporate working this system for the state. About 77% of Ok-12 households voluntarily reported their outcomes again to a sampling of colleges, in keeping with the corporate.
As well as, the state is paying Major Well being to function greater than 7,000 free testing websites — most of that are in colleges — through the use of leftover federal covid aid cash disbursed to states at first of the pandemic.
How lengthy that funding will final isn’t clear.
“It looks like the federal authorities is stepping again and saying this portion of well being care goes again to well being care as we all know it,” mentioned Abigail Stoddard, Major Well being’s normal supervisor of presidency and public packages.
Stoddard’s conversations with colleges exterior California are altering. As an alternative of conducting surveillance testing to find out whether or not the virus is circulating on campus, as California is doing, many are transferring towards testing solely children with signs, she mentioned.
For instance, Major Well being operates in Minnesota, the place colleges are making use of for grants to fund testing and can resolve whether or not checks will likely be for sick college students, wholesome ones, or simply staffers.
Native Free Testing
Free testing remains to be obtainable in California via some hospitals, neighborhood clinics, native well being departments, and personal corporations working with the state, though how lengthy these choices will stay is unclear.
In Sacramento County, the lack of federal funding for testing uninsured individuals has gone largely unnoticed up to now. “Our hope is that we now have sufficient providers and assets in the neighborhood that the extra protection going away is not going to have a big impact,” Kasirye mentioned.
The county well being division nonetheless affords free neighborhood testing to uninsured individuals on daily basis at church buildings or neighborhood facilities.
However they could get tougher to seek out. The testing firm Healing used to supply free lab-run PCR and fast antigen checks across the state, however now that the federal funding has run out, it affords solely PCR checks to the uninsured at no cost. The corporate has additionally diminished the variety of its websites, from 283 on April 14 to 135 on April 19.
In some states, Healing has both stopped testing uninsured individuals — or is charging them $99 to $135 per take a look at.
This story was produced by KHN, which publishes California Healthline, an editorially impartial service of the California Well being Care Basis.