Many Long Islanders accustomed to free COVID-19 testing will now have to pay more than $10 for home kits, with in-office testing prices expected to average $130 to $150, leading experts to predict some may stop be tested.
The May 11 expiry of the COVID-19 Federal Public Health Emergency meant that the government could no longer require insurers to pay up to eight home tests per month for each person covered by the policy, and the federal government is to end free distributiontests by mailafter Wednesday.
The insurance mandate for free outpatient PCR and rapid testing in places such as doctor's offices and emergency rooms has also expired. The cost to obtain a rapid test or antigen test will now typically be around $130, including office visit fees, and the typical cost for a PCR test is estimated at $150, according tolast analysisby KFF, a San Francisco-based non-profit health policy organization.
COVID-19 is now more like other diseases as consumers may face high bills, unexpected costs and tough choices on whether to forego care or testing because they are too expensive, said Jennifer Kates, vice president and director of KFF, previously known as the Kaiser Family Foundation.
WHAT TO KNOW
- Most COVID-19 tests no longer existis free due to changes in federal regulations. The average home rapid test costs $11, and a rapid test or PCR in clinics costs $130-150, according to the analysis.
- Medicaid still covers testingand there are several state-funded health centers with free tests. But many insurance companies no longer pay for home tests, and lab tests may include co-payments or deductibles.
- Experts fear the end of free trialsfor many Americans, this means more people will be unknowingly spreading the coronavirus, and some may get sick because they didn't seek treatment early enough.
"In general, we're going back to the American healthcare system as we knew it," she said. “Simply with COVID, costs and access were protected due to the emergency. And now many of those safeguards have ended or will end."
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Those who can afford testing will continue to test, predicts Mara Aspinall, a practice professor and expert in biomedical diagnostics at Arizona State University.
"For a family of four, it's very difficult for many, many Americans to add that as an extra expense," said Aspinall.
The average cost of a quick home test was $11 last month, according to KFF analysis.
Will the Long Islanders continue to test?
In interviews, Long Islanders were divided on whether to continue testing.
Dave Ali, 47, from Roslyn, said he would pay for the test.
"I have a family at home and I have children at home," he said. "I definitely want to know if I'm exposed to anything so I don't get sick."
But Ali said: "For some people, $11 is a lot to pay for a COVID test. Some people will look at it and say, 'OK, I'm making a decent salary. It's $11." But for some families, that would mean dinner or not."
A national survey last year found that nearly a quarter of those who received free tests from the federal government would probably never have been tested otherwise, and black respondents were particularly unlikely not to use other home test kits, researchers wrote. Inand an article from Aprilin the Federal Government's Weekly Morbidity and Mortality Report.
Jayla Thomas, 18, of Uniondale, said she had previously used free, rapid home tests "when I felt like I was sick."
But when told that tests now average $11, Thomas, a freshman at St. John's University is "not worth" testing, because the result would probably be negative anyway.
"It should still be free," she said. "If not, your insurance should find a way to cover it."
Newsday's review of several major insurers found that almost none of them currently provide free home tests, and one that still does did not say how long the program will run. Everyone says that, depending on the policy and deductible, tests performed at outpatient facilities such as doctor's offices may include a co-pay or deductible.
Kates said it was unclear how many insurers would continue to cover testing now that they were not obligated to do so.
There are still a few places where Long Islanders can get free home tests.
Medicaid and the Children's Health Insurance Program, as well as a basic plan for lower-income New Yorkers who don't qualify for Medicaid, will offer free testing until at least September 2024, said a spokeswoman for the state health secretary, Danielle DeSouza.
Uninsured individuals may also receive tests at the following Long Island locationsfederal programbut only if they have been exposed to COVID-19 or have symptoms.
Sun River Health, which operates 11 Suffolk federal health centers that serve a large number of uninsured and underinsured people, continues to distribute four free home tests provided by the federal government to anyone who requests them, regardless of income level, said Roberta Kelly, Senior Sun River nurse. Sun River also offers free PCR tests while federal supplies last.
Harmony Healthcare Long Island, Nassau's equivalent of Sun River, manages on-site testing and bills insurers for those covered, said David Nemiroff, president and CEO of Harmony.
"We do very, very little testing," he said. "Where we were making hundreds a day, now we're lucky if we're doing 50 a week."
Drop in sales of COVID tests
Even before costs took effect, sales of COVID-19 tests plummeted, according to data from NIQ, a data and analytics company. There were 802 million OTC test sales in the first quarter of 2022, up from 173 million in the first quarter of this year.
Aspinall said that's partly because there are fewer COVID-19 cases and deaths, and companies, healthcare facilities and others that used to require testing are no longer doing so. But it's also because most Americans don't think about COVID-19 as much as in the past, she said.
"It was constantly on people's minds and the numbers were high," she said. "Fortunately, we're in a completely different phase now."
However, she said testing is essential to protect those for whom COVID-19 remains a serious potential threat, such as the elderly and people with compromised immune systems.
Those who don't test may become more seriously ill than if they were tested and accessed treatment, said Martine Hackett, director of public health programs at Hofstra University.
And anyone who unknowingly has COVID-19 could put others at risk, she said.
"It means they can spread it without realizing it," she said.
Testing costs are not the only expenses new COVID-19 residents will face.
The federal government is expected to run out of stocks of Paxlovid, a COVID-19 drug for people at higher risk of severe COVID-19 that the government is providing free of charge later this year, Kates said.
Pfizer did not disclose the market price - Kates said it would likely be more than $530 a share. treatment paid for by the government - and company spokesman Kit Longley said in a statement that "costs to patients will vary and are determined by insurance companies".
Kates said that, as with other drugs, some people Paxlovid can help may choose not to pay for it, "and that has consequences for their health."
The government may also run out of free vaccines, or the federal authorities may recommend a new vaccine that will be better able to fight the ever-changing virus. But even if the vaccines make it to the private market, they will usually be free, Kates said. She said insurers are required to pay for every COVID-19 vaccine and some other vaccines administered online. And the federal program now provides vaccines to the uninsured.
EXTENSION OF THE EXPIRY DATE
- Covid-19 home test expiration datecould be extended. To check, go to https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/home-otc-covid-19-diagnostic-tests#list
- If your test has really expired,do not use it, advises US Food and Drug Administration COVID-19 tests and the parts they are made of can degrade or break down over time. For this reason, expired test kits may produce inaccurate or invalid test results.
David Olson works in healthcare. He has been with Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.