Biden doesn't say unfunded mandate, but it is
The Biden administration announced its intent to stop paying for COVID vaccines and treatments. Welcome to the latest unfunded health care mandate!
At present, the federal government is paying the costs of mandatory vaccination as well as selected treatments for those who are ill with COVID. Ivermectin, declared unsafe by the FDA, is not approved for use against COVID and therefore generally unavailable.
The vaccines and approved treatments have been provided at no charge to patients while hospitals, pharmaceutical manufacturers, and pharmacy benefits managers have been well compensated, paid with taxpayer dollars and fiat money (a primary driver of inflation).
Though Washington will cease paying for the medicines, the mandates and coercive behaviors remain in effect. Though the CDC has admitted "dramatic mistakes" regarding COVID; though it has reversed itself on almost every one of its COVID pronouncements; and even though Pfizer falsified its pre-release vaccine test results, Drs. Jha (surgeon general) and Fauci warn there could soon be another push for more vaccinations and boosters.
A push for vaccinations and boosters is likely despite mounting evidence of the health damage and deaths, including fetal deaths, resulting from mRNA technology used for mass vaccination. But ignore for a moment the medical harm, and consider fiscal impact.
With mandates in place or renewed, insurance companies will be required to provide these benefits to all privately insured Americans. Their added costs will be passed on as even higher medical insurance premiums and larger co-pays. So insured persons will be funding the new unfunded (COVID) mandate.
More than 75 million Americans have no-charge, government-supplied Medicaid insurance. Though Medicaid has failed to deliver timely or even adequate medical care, it is certain that the Centers for Medicare and Medicaid Services will require all contracted insurance companies to provide the vaccines, boosters, and approved anti-viral drugs. They will increase their fees to cover the costs of additional benefits, and taxpayers will foot this bill — a well hidden new unfunded mandate.
An estimated 26 million Americans have no health insurance or are underinsured. At present, it is unclear how Washington will provide the anti-COVID therapies to this population, but there is a strong commitment to set up the "kind of systems ... to maintain some kind of 'access and equity.'" Both the medications and the supporting bureaucracy will, undoubtedly cost many more billions of taxpayer dollars. It's a third unfunded mandate, attributable to President Biden.
There is an instructive experience with unfunded mandates, starting with the Emergency Medical Transport and Labor Act of 1986. Known as the anti-dumping law, EMTALA required hospitals to provide whatever care is needed for a seriously or critically ill person presenting in the E.R., regardless of whether the hospital and physician will be paid or not. For example, an uninsured individual having a heart attack will receive all medically required care, including open heart surgery, even a transplant, and a lengthy stay in the ICU. The bill will easily top $250,000, and the hospital will receive nothing.
(It is likely that Joe Biden, in Congress from 1979 to 2009, voted for the first unfunded mandate, EMTALA.)
A hospital will either have to "find" money to offset the huge losses from unfunded mandates or close its doors. That is what is happening to hospitals that provide care to the underserved, especially rural and inner-city institutions. In 1960, there were 310 small rural, only-facility-in-the-area hospitals in Texas. Today there are fewer than 150. With the new COVID-related unfunded mandates, expect even more hospital closures and even less access to care.
Who pays for unfunded mandates? Taxpayers do, through higher taxes and increased insurance premiums. Biden's new COVID unfunded mandate will simply be one more money-grab added to other unfunded mandates, to his inflationary spiral, and his additional taxes in the self-contradictory Inflation Reduction Act.
PS: No cost analysis has been offered for this new mandate. President Biden just wrote another blank but no doubt multi-billion-dollar check for the American people to pay.
Deane Waldman, M.D., MBA is professor emeritus of pediatrics, pathology, and decision science; former director of the Center for Healthcare Policy at Texas Public Policy Foundation; and author of the multi-award-winning book Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine.