When Dr. Catherine Troisi ordered several at-home COVID-19 testing kits last week, she was able to put her delivery through but received a message that her shipment would be delayed.

Troisi, who is an infectious disease epidemiologist with UTHealth Houston School of Public Health, said she expects many people to receive similar notifications, as manufacturers are already seeing a rise in demand with the end of the COVID-19 public health emergency declaration approaching on Thursday, May 11.

“I went to order my tests from my insurance company and although I did get them, it took longer because they’re already seeing an increase in need,” she said.

Both private and public insurers will no longer be required to cover the costs of these test-kits, which for the last two years have been provided to the public for free. This is causing many people – whether they are insured, underinsured or uninsured – to take the last opportunity they have to access these tests for no costs, Troisi said.

The termination of coverage will affect access to these tests for everyone; however, the population of people it will most impact are the uninsured as they have no insurance to get a fraction of the cost of these tests deducted, she said.

Whereas those covered by private insurers – whether self-insured or insured by their employer – may have at least some of the costs covered despite needing to pay a co-pay (their share) of the test.

But even these populations will face a roadblock, as it is uncertain whether manufacturers will be producing enough of a supply of at-home test kits. This could inhibit doctor’s offices and retail pharmacies from being able to stock plenty for their patients and customers respectively, according to the Kaiser Family Foundation.

Troisi is concerned that a lack of access to these tests would mean a rise in case numbers and an increase in potential risks of exposure to the virus.

Dr. Vivian Ho, James A. Baker III Institute Chair in Health Economics and Professor of Economics, said the lack of ability to obtain these tests will certainly result in less testing, “There are people – particularly with the amount of inflation we have in the economy – that budgets’ are tight and the cost of a test is going to discourage them from getting tested,” she said.

Currently, at-home COVID-19 tests at the pharmaceutical company CVS are $28.99 each and included inside are two tests that provide rapid results in 10 minutes, according to CVS online.

These at home-testing kits can vary in costs, depending on where they are provided and who is purchasing them, Ho said.

A variety of costs will continue even for those who are insured – as each private insurance company will be able to decide whether or not they want to provide coverage and how much they want to deduct from total costs.

“I am hoping they’re able to negotiate the lowest possible prices for those tests,” Ho said. “Once you get insurers negotiating, I am worried that the actual prices of the tests may be higher.”

Although, Medicaid plans are extending coverage until the end of September 2024, currently, Medicare Plan B is only covering costs of lab-tests – but not at-home tests.

If federally-funded plans like Medicare do not waive the costs of these tests, Troisi said it places those who are in the vulnerable, high-risk populations – like older residents and low-income families (those under Medicaid) that already have a higher chance of having a pre-existing health condition – at a disadvantage.

“If you are a low-income family and you are going to visit grandma, maybe with free test kits you would test just to make sure that you’re negative,” Troisi said. “But now, you might think twice about it, so I am afraid that this might be an unintended consequence that we do see cases go up simply because people aren’t testing because of associated costs.”

Troisi said some efforts are in order to keep more tests available to the public, without them having to purchase more – one of which was the FDA’S announcement of extending expiration dates.

Depending on the kind of kit an individual has, they can now go on the FDA’s website and look up their test and see what date the active expiration date was extended too.

Although they tend to expire between six to eight months, which still provides only a temporary solution to a larger issue, Troisi said.

“The problem is they are still going to eventually expire, they can’t be good forever, so yes you’ll be covered for several months, but then if you need them, you’ll have to get them through your insurance or pay for them,” Troisi said. “And cases are going to start to go up and we are going to have to start those precautions again and I am just not sure if that’s going to happen.”