Biden Administration Will Fund Program to Keep Covid Vaccines Free for the Uninsured

WASHINGTON — The Biden administration plans to spend more than $1 billion on a new program to offer free coronavirus shots to uninsured Americans after the vaccines move to the commercial market later this year, administration officials said on Tuesday.

The program for the uninsured, which will be modeled partly on an existing childhood vaccination program and will cover an estimated 30 million people, will include a first-of-its-kind partnership with pharmacy chains in which the government will pay the administrative costs of giving the doses to patients. Pfizer and Moderna have pledged to offer the shots at no cost to those who lack insurance.

The administration’s move partly resolves a critical gap in the nation’s coronavirus strategy ahead of a new vaccination campaign with reformulated shots that is likely to begin as soon as late summer. Federal officials have said that they no longer plan to purchase doses for all Americans as they have in prior coronavirus vaccination campaigns, allowing the vaccines to be sold commercially and ceding power to manufacturers to set their own prices.

The new vaccine initiative comes as the administration is looking beyond the coronavirus public health emergency, which was first declared under President Donald J. Trump in 2020 and has been extended under President Biden. The administration plans to allow the emergency to expire on May 11, setting the nation on a course when Covid-19 will be treated as just another respiratory disease, like influenza.

The vaccine initiative has been a priority of Mr. Biden’s secretary of health and human services, Xavier Becerra, and will also cover some costs associated with Covid-19 treatments for the uninsured. In addition, the administration is working on a $5 billion program to spur next-generation coronavirus vaccines and treatments, Dr. Ashish K. Jha, Mr. Biden’s Covid-19 response coordinator, said in an interview.

“Covid is not over,” Dr. Jha said. “And while we are transitioning out of the public health emergency and all of the flexibilities it provided, we’re committed to making sure that we continue to fight Covid. And that means making sure people have access to vaccines, treatments and tests.”

The end of the public health emergency will not have any immediate impact on Americans’ ability to gain access to coronavirus vaccines. For now, those looking to get vaccinated or boosted can still get shots at no cost from the stockpile of doses the federal government already has in hand. That includes an additional round of updated booster shots for people 65 and older or those who are immunocompromised, which the Food and Drug Administration authorized on Tuesday.

In June, federal regulators are expected to choose a new formulation for coronavirus vaccines that will target versions of the virus they expect to circulate broadly later in the year. Those retooled shots will most likely roll out around September, similar to the timing of last year’s booster campaign.

The administration’s new initiative will be called the Bridge Access Program for Covid-19 Vaccines and Treatment. As part of the program, federal officials will also purchase vaccines and distribute them to state and local health departments.

When coronavirus vaccines move to the commercial market, Pfizer and Moderna have said they plan to charge over $100 per dose, or roughly four to five times the price the federal government paid for the companies’ shots in the most recent booster campaign. Dr. Jha said White House officials “don’t think that kind of price increase is justifiable.”

For most Americans, the reformulated shots later this year will not bring any out-of-pocket costs. Most private health plans will cover them, as will Medicare and Medicaid. The costs of doses for uninsured children will be covered by the federal Vaccines for Children program.

Last year, the Biden administration proposed creating a program called Vaccines for Adults, which would mimic the concept used for uninsured children. But administration officials have been unable to persuade lawmakers to establish such an initiative.

For the new program, the administration is counting on substantial help from the companies making the vaccines. In February, Moderna said it would use a so-called patient assistance program to provide doses free of charge to uninsured Americans. Pfizer plans to offer free vaccines through a similar program, a company spokeswoman said.

The details of those programs are still being worked out. Jennifer Kates, a senior vice president at the Kaiser Family Foundation, said pharmaceutical company assistance programs varied by company and medication, a patchwork system that she said could be complicated and inaccessible. Companies often require proof of income or proof that a patient is uninsured, Dr. Kates said.

“It’s a Band-Aid,” she said of the assistance programs. “The problem is that these are not mandatory or sure bets. These are voluntary efforts by companies.”

The uncertainty around how long the drugmakers’ programs might last, she added, “raises the question of whether this is a permanent solution that people can totally rely on.”

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