SACRAMENTO, Calif. — California continues to be providing free covid testing to uninsured residents despite the fact that the federal authorities ran out of cash to pay for it.

Whereas Congress debates whether or not to place more cash into free testing, California is leaning on applications it already had in place: particular state-based protection for uninsured Californians, college testing, and free assessments provided by clinics, counties, and different teams. Absent free choices, individuals with out medical insurance might pay as a lot as several hundred dollars out-of-pocket relying on the place they get examined.

On the identical time, demand for group testing — from residents with and with out insurance coverage — has dropped precipitously.

On a current Thursday, solely three individuals might be discovered getting examined at seven testing websites in Sacramento County. Staffers at these places — from the previously bustling mass-testing website on the state fairgrounds to a tiny kiosk in a church car parking zone — stated hardly anybody exhibits up anymore despite the fact that testing continues to be necessary for monitoring and lowering the unfold of covid-19. They principally see regulars who are available for routine testing required by their employer or college.

Dr. Olivia Kasirye, the general public well being officer for Sacramento County, stated the county sends specimens to a state lab for gratis to the county, which has helped preserve free testing providers up and working. California is quietlyending its contract with a central lab, however the state says it’s going to shift testing to a community of business labs. State officers advised KHN there might be no modifications for sufferers.

“I feel we are able to preserve providers” for now, however the future is unsure, Kasirye stated.

For the reason that starting of the pandemic, the federal authorities had reimbursed suppliers for testing, treating, and vaccinating uninsured individuals for covid-19. However the Health Resources and Services Administration stopped accepting reimbursement claims for assessments and coverings March 22, and for vaccinations April 5, saying the cash had run out. The federal government had been reimbursing suppliers $36 to $143 per check.

Since then, states and counties have been watching their case charges and coffers to see whether or not they can preserve testing uninsured residents.

In Alabama, Dr. Scott Harris, the state well being officer, stated providing free testing to individuals 5 days per week by county well being departments is “in all probability not one thing we’re going to have the ability to maintain for much longer,” particularly in pockets of the state with massive uninsured populations.

“We’re going to have zero providers for these individuals,” Harris stated. “And no potential to incentivize suppliers to see them.”

Congress returns from recess in late April however might not renew this system. Lawmakers beforehand thought of extending it however selected to not embrace cash for it in a $10 billion covid funding deal that’s been pending since early April.

The Covid-19 Uninsured Group

Well being care advocates say California has been capable of proceed free testing for the uninsured, together with for residents with out authorized documentation, due to the way it used a separate pot of federal funding. Though 15 other states additionally leveraged pandemic assist, advocates consider California expanded advantages probably the most.

In August 2020, California created an insurance coverage program with pandemic aid cash to cowl covid-related therapies, testing, and vaccines for uninsured individuals or these whose insurance policy don’t cowl these providers. The Covid-19 Uninsured Group basically acts as Medicaid for covid, however with no earnings necessities. That’s completely different from conventional Medi-Cal, California’s Medicaid program, which is for low-income individuals.

Protection will finish when the federal public well being emergency does. On April 13, the U.S. Division of Well being and Human Companies renewed the emergency declaration for 90 days, extending it to mid-July.

The state program is a intelligent approach to make use of federal {dollars}, stated David Kane, a senior lawyer on the Western Middle on Legislation & Poverty. However he famous there are drawbacks. Individuals should be enrolled earlier than they will acquire providers, they usually can’t enroll themselves. Solely sure well being care suppliers, principally hospitals and clinics, can signal individuals up.

“This system was by no means designed to exist in isolation,” Kane stated, “however now it does.”

About 291,000 individuals had been enrolled in this system as of April 4, in line with Anthony Cava, a spokesperson for the state Division of Well being Care Companies, which administers Medi-Cal. An estimated 3.2 million Californians, or round 9.5% of individuals youthful than 65, are uninsured.

Kane recommended that individuals discover a certified supplier from a database maintained by the Division of Well being Care Companies or by calling the Medi-Nurse line and get enrolled as quickly as potential, particularly if they’re used to strolling as much as a testing website and paying nothing.

The problem is getting individuals to enroll earlier than they get sick or want a check, Kane stated, and maintaining this system going with the added affected person load.

Screening College students

One other main supply of free testing in California is public faculties.

California distributed greater than 14.3 million at-home tests to colleges earlier than college students left for spring break. The faculties in flip handed out the fast assessments to households to allow them to display college students earlier than sending them again to campus. The state had the same program for the winter holidays.

The winter testing was “extremely efficient,” in line with Major Well being, the corporate working this system for the state. About 77% of K-12 families voluntarily reported their outcomes again to a sampling of colleges, in line with the corporate.

As well as, the state is paying Major Well being to function greater than 7,000 free testing websites — most of that are in faculties — through the use of leftover federal covid aid cash disbursed to states at first of the pandemic.

How lengthy that funding will final isn’t clear.

“It looks like the federal authorities is stepping again and saying this portion of well being care goes again to well being care as we all know it,” stated Abigail Stoddard, Major Well being’s normal supervisor of presidency and public applications.

Stoddard’s conversations with faculties exterior California are altering. As an alternative of conducting surveillance testing to find out whether or not the virus is circulating on campus, as California is doing, many are transferring towards testing solely youngsters with signs, she stated.

For instance, Major Well being operates in Minnesota, the place faculties are making use of for grants to fund testing and can determine whether or not assessments might be for sick college students, wholesome ones, or simply staffers.

Native Free Testing

Free testing continues to be accessible in California by some hospitals, group clinics, native well being departments, and personal firms working with the state, though how lengthy these choices will stay is unclear.

In Sacramento County, the lack of federal funding for testing uninsured individuals has gone principally unnoticed thus far. “Our hope is that we’ve sufficient providers and sources locally that the extra protection going away is not going to have a huge effect,” Kasirye stated.

The county well being division nonetheless affords free group testing to uninsured individuals every day at churches or community centers.

However they might get more durable to seek out. The testing firm Healing used to supply free lab-run PCR and fast antigen assessments across the state, however now that the federal funding has run out, it affords solely PCR assessments to the uninsured for free. The corporate has additionally diminished the variety of its websites, from 283 on April 14 to 135 on April 19.

In some states, Healing has both stopped testing uninsured individuals — or is charging them $99 to $135 per check.

This story was produced by KHN, which publishes California Healthline, an editorially impartial service of the California Health Care Foundation.

Rachel Bluth: [email protected], @RachelHBluth