Dive Brief:
- Insurers will now be required to reimburse members who buy at-home COVID-19 tests, President Joe Biden announced Thursday. The move matches earlier policy decisions that force payers to cover tests administered in healthcare settings.
- Nearly 150 million insured Americans will benefit from the move, helping to lower their costs for the over-the-counter tests that can retail for around $25 for one kit.
- The plan is designed to make it easier to detect and contain the virus heading into the winter when many are expected to gather indoors, and as the omicron variant is detected in the U.S.
Dive Insight:
Biden released a multi-pronged plan Thursday to battle COVID-19 during the winter, a time that could pose difficulties as experts expect cases to rise at the same time as a potentially more contagious variant arrives in the U.S.
Among requiring insurers to reimburse members for at-home tests, Biden announced four other key actions as part of his winter plan to beat back the virus, which includes ramping up messaging around boosters and standing up family vaccination clinics, a one-stop shop for immunizations for the entire family.
The message from Biden on Thursday was clear: Worried about the omicron variant? Get vaccinated.
"My plan I'm announcing today pulls no punches in the fight against COVID-19," Biden said Thursday from the National Institutes of Health. He did say there were no plans for lockdowns.
The winter plan comes one day after the U.S. reported its first detected case of the omicron variant, in a San Francisco resident who had recently traveled to South Africa where the variant was first detected.
The World Health Organization labeled omicron a variant of concern based on evidence that it has several mutations that may make it more infectious and may cause more severe illness.
The variant news has intensified pleas from public officials for Americans to get vaccinated and seek out a booster dose. Nearly 60% of the U.S. population is fully vaccinated and just 21% have received a booster dose, according to the Centers for Disease Control and Prevention.
More than 100 million are eligible for boosters but have yet to get the jab. Biden urged people to "go get it now."
In an effort to help contain the spread, the administration will require insurers to reimburse members who purchase the at-home tests. Biden told Americans insurers will begin to cover the at-home tests next month.
The cost for payers will likely be significant if millions of Americans are eligible for reimbursement. Neither Biden nor the insurance lobby commented directly on the estimated costs insurers will bear.
The insurance lobby seemed supportive of Biden's plan and said the at-home tests are an important tool to ultimately limit the spread of the virus.
"Every American deserves access to vaccines, testing, and treatment to protect them from the COVID-19 virus, especially with the uncertainty of a new variant," AHIP said in a statement.
AHIP also said it's committed to ensuring that "price gouging does not spread to OTC tests, [and] that consumers are protected from higher premiums."
For the roughly 28 million Americans who do not have insurance, Biden said they will make test kits available for free at thousands of locations.
Even though it's a step in the right direction some said it may lead to a "shoebox effect" in which people hold on to receipts for the kits but "never get around to filing for reimbursement," Larry Levitt, executive vice president of health policy for Kaiser Family Foundation, tweeted Thursday ahead of the news. By contrast, other countries have made these tests free in stores and online, he added.
The plan is a potential boon for medtech companies that produce at-home tests. With insurers on the hook for payment, it may drive up demand, particularly among those who were sensitive to prices before. Abbott, BD and Quidel are big players in the at-home testing space.