Coronavirus vaccine could be free, thanks to Obamacare - Business Insider - Business Insider

• Public concern is rising that the high costs in parts of the US's healthcare system could form a barrier that discourages people from getting treatment for the novel coronavirus.
• But one layer of the healthcare system could help Americans save a lot of money on a coronavirus vaccine: Obamacare.
• Under a little-known provision of the Affordable Care Act, health insurers must cover federally recommended vaccines at no cost for patients.
• The ACA has the potential to form a critical pillar in a federal strategy to combat the spread of a fast-moving coronavirus.
• Visit Business Insider's homepage for more stories.

The coronavirus is spreading around the world and scores of new cases are diagnosed daily, as the disease breaks far beyond its point of origin in Wuhan, China.

There are at least 63 confirmed coronavirus cases in the United States. But that figure is still significantly fewer compared to other nations. Europe has seen a surge of new infections in recent days, bringing the total number to over 85,100 people in 56 nations. The overwhelming majority — 95% — of cases remain in China.

Health officials, though, are warning that its spread in the US is "inevitable" and urging Americans to prepare, holding out the possibility of school closings, workplace shutdowns, or the cancellation of large public gatherings.

Yet public concern is rising that the US's expensive healthcare system could create a barrier discouraging people from seeking life-saving care for COVID-19 — the disease caused by the coronavirus — and accelerate its spread around the country.

Health and Human Services Secretary Alex Azar heightened those anxieties this week when he initially said the government couldn't control prices for coronavirus treatments because "it needed the private sector to invest." He later walked back those remarks after triggering massive backlash.

A cautionary tale also sprung onto the public eye. Earlier this week, the Miami Herald reported that a local resident named Osmel Martinez Azcue had recently returned from China with flu-like symptoms and decided to test himself for the coronavirus at a hospital. He tested positive for the flu, and not the virus.

But his prudence came at a cost. Azcue had a skimpy short-term health insurance plan which critics deride as a "junk plan." As a result, he racked up a substantial bill for being tested. Azcue received a claim from his insurer for $3,270 and will have to pony up at least $1,470, the newspaper reported. He's on the hook for more.

Yet one layer of the healthcare system could help Americans save a lot of money on a potential coronavirus vaccine: the Affordable Care Act, also known as Obamacare.

A little-known provision of Obamacare would likely make any coronavirus vaccine free for most people with health insurance. Plus, the law expanded insurance coverage for roughly 20 million Americans and widened access to medical care. Those components underscore the law's broad reach across the healthcare sector and its potential to form a pillar in a federal strategy to combat the spread of a deadly, unknown disease.

"There's an important link between broader healthcare policies like the Affordable Care Act and responding to a potential public health emergency like this virus," Larry Levitt, the executive vice president for health policy at the Kaiser Family Foundation, told Business Insider.

Levitt added that providing people access to inexpensive healthcare is "key to both preventing the spread of a virus like this and getting people who are sick treated."

Obamacare basically makes many vaccines free

The development of a vaccine that successfully treats COVID-19 is still far off — at least a year in the best case scenario, given the rounds of rigorous testing involved.

Under the ACA, health insurers must cover federally-recommended vaccines at no cost for most people, according to John Cogan, a professor of health insurance law and financial regulation at the University of Connecticut.

"Everyone under Obamacare would be covered under this vaccination without cost-sharing," Cogan told Business Insider. That would extend to the health insurance people get through their employers, as well as to most health insurance programs like Medicaid for children and people with low incomes, he said.

The cost of getting a shot has surged over the last two decades, the New York Times reported. The price of an influenza vaccine can range anywhere from $20 to 40 a shot, meaning a family of four could pay up to $160 a year. Then a shingles vaccine recommended for people 50 years and over can cost upwards of $140.

"The vaccines that we rely on everyday are expensive. They're not $10,000 a shot, but they're costly enough that a lot of people can't afford them," Cogan said.

President Obama's signature law — passed in 2010 —bans insurers from applying co-pays, deductibles, and co-insurance to vaccinations recommended by the US Centers for Disease Control and Prevention, ensuring they're basically free for patients covered under those plans.

President Barack Obama signs the Affordable Care Act in the East Room of the White House on March 23, 2010.

J. Scott Applewhite/AP

A similar provision of the law makes other kinds of preventive healthcare, such as mammograms and annual checkups, free for patients, as long as they get them from a doctor who accepts their insurance.

'Vaccines and antivirals can't simply be sold to the highest bidder'

Cogan said he's still concerned about whether a coronavirus vaccine will be affordable, given the Trump administration's support of a lawsuit that would scrap Obamacare in its entirety.

He noted that Trump has sought to weaken and dismantle the health law throughout his presidency— one way was introducing cheaper short-term insurance plans that don't cover costly services like hospital care or protect people with pre-existing conditions.

The ACA's free-vaccine requirement doesn't apply to those short-term plans, meaning people with that type of coverage would have to pay out-of-pocket to get a vaccination. The White House also ended subsidies helping to keep cost-sharing down, pricing out some people from getting ACA-compliant insurance.

Cogan said that Azar could ensure Americans can get a potential vaccine by stopping efforts to unravel Obamacare.

"If he wants to make it affordable, back off attacking the ACA. Because that will make it affordable for most people," he said.

Cogan isn't the only one thinking about the potential cost of a coronavirus vaccine. Bill Gates, who's supporting efforts to come up with a vaccine and fight the coronavirus outbreak, wrote on Friday that any breakthrough treatment has to be reasonably priced.

"During a pandemic, vaccines and antivirals can't simply be sold to the highest bidder," Gates wrote in the New England Journal of Medicine. "They should be available and affordable for people who are at the heart of the outbreak and in greatest need. Not only is such distribution the right thing to do, it's also the right strategy for short-circuiting transmission and preventing future pandemics."