Federal Reimbursement Ends At NJ's COVID Testing, Treatment Sites

Update: This article now includes a response from the New Jersey Department of Health.

NEW JERSEY — New Jersey residents who don’t have health insurance can soon expect to pay for COVID-19 tests and treatment with the end Tuesday of a federal program that reimbursed providers for virus-related care.

One of the immediate implications of the expiration of the Trump-era provider relief program: People in New Jersey and elsewhere who haven’t received their COVID-19 booster shots, or even the first in the vaccination series, should do so before April 5, the last day the Uninsured Program will accept vaccination claims.

The program has already stopped accepting claims for testing and treatment. The reimbursement program was launched in 2020 with $100 billion in funding, and another $78 billion was appropriated later.

The White House’s decision to end the program — due to a lack of funding — also means that, soon, hospitals and other health care providers in New Jersey can no longer bill the government for things such as administering COVID-19 vaccines to people who don’t have health insurance.

The federal government has bought the doses necessary to vaccinate children up to age 5 for the pending approval of doses for the age group, according to the Associated Press. But the Biden administration says it lacks the funds for any additional doses that may become recommended, or for any potential need to develop variant-specific COVID vaccines.

The provider relief funding is ending as the numbers of COVID-19 infections, hospitalizations and deaths continue to decline across the country. But a new surge in cases in Western Europe has health officials and experts worried that cases may again go up in the U.S. as well.

It remains uncertain whether New Jersey has the funds or plans to cover any costs for COVID vaccines, testing or treatment once covered through federal funding. Patch reached out to spokespersons for Gov. Phil Murphy's administration and the New Jersey Department of Health.

A state health department spokesperson emailed Patch the following statement Thursday:

"The New Jersey Department of Health’s focus during the COVID pandemic has been on equitable access to COVID-19 vaccines, treatments, and testing, which enable better individual and public health outcomes. It is too soon to say what the specific impact of a lack of federal funding will be, but the Department is monitoring for changes to our provider networks — especially in our most vulnerable communities.

Federal resources play an important role in bolstering our supplies of testing, therapeutics and vaccines to help us provide residents — especially those in high-need areas — with adequate access. Federal funding helps Federally Qualified Health Centers (FQHCs) and local health departments provide COVID-19 vaccines to the uninsured. Many FQHCs also received federal at-home test kits to disseminate to patients. Our state also supplies free Vault saliva-based at-home test kits and provides FQHCs some reimbursement for lab fees for medically necessary testing."

The BA.2 variant known as "stealth omicron" has caused record and near-record COVID surges across East Asia and Europe. Health officials remain uncertain whether the strain will cause another significant wave in the United States. But BA.2 became the dominant variant in the New Jersey-New York area as of Tuesday, according to the Centers for Disease Control and Prevention. Read more: 'Stealth Omicron' Becomes Dominant Variant Around NJ

So far, New Jersey hasn't seen BA.2 propel any significant jump in cases. The state averaged 1,012 daily infections in the past week after seeing 846 per day for the prior week, according to federal data. COVID hospitalizations in the state continue to decline, and the state's rate of transmission stood at 0.95 as of Thursday, according to the state health department. (A transmission rate below 1 means the virus's spread is decreasing. The closer the figure is to zero, the faster the reduction in spread.)

But as New Jersey attempts to move from the pandemic into a more "normal" phase of life, the lack of federal funding to fight COVID could give the state new challenges in managing future surges.

The White House wanted $22.5 billion in coronavirus funding in the $1.5 trillion omnibus spending bill passed by Congress earlier this month, but Democrats dropped the request amid disputes that threatened other priorities. Among the points of contention: Republicans wanted to reallocate coronavirus aid previously allocated to states.

The federal government has $300 billion from last year's $1.9 trillion COVID-relief measures, Biden administration officials told the AP. But about $240 million has been promised to specific recipients, such as states and cities.

Health advocates say continued funding is critical for about 28 million Americans who don’t have health insurance. Enrollment in Medicaid and children’s health insurance programs rose sharply during the pandemic to about 85 million people last fall, according to an analysis by the Kaiser Family Foundation.

Elimination of the provider relief fund deals a strong blow to “those who have the greatest risks, due to lower resources and less access to usual care,” Dr. Howard Forman, a professor of public health at the Yale School of Medicine, told NBC News.

Even people who have insurance may find themselves questioning if they can afford to get care, Forman added.

“Think about the person with a large deductible who would readily access a free monoclonal antibody clinic or testing site for testing and early treatment, but who might be afraid of large bills if they went to a private physician or even a hospital,” he told NBC.

The elimination of coronavirus spending in the omnibus bill has left the Biden administration's new COVID-19 road map in some doubt. The decision to save the fight for later underscores the deep partisan divides over the pandemic and the government's response to it but also shows the pandemic is no longer the government's top priority.

Without an infusion of cash in a provider relief program, COVID-19 patients without insurance likely will have to depend on their local hospital’s charity and financial assistance programs, which can vary greatly and can be difficult to navigate, according to Kaiser Health News.

The American Hospital Association, a trade industry group, said in a letter to congressional leaders Wednesday that it supports the Biden administration’s request for more COVID-19 assistance, including that earmarked for the provider relief program.

“While the nation remains weary and is eager to move past this pandemic, the virus continues to evolve and pose a threat to our nation’s health care system,” the hospital group said.

“The recent surge of cases and hospitalizations abroad fueled by the Omicron variant known as BA.2 serves as a critical warning: The battle is not over, and hospitals and health systems continue to need resources and flexibilities to care for patients and protect communities.”