Hospitalizing Americans who aren't vaccinated against the coronavirus is leading to billions of dollars in unnecessary health care costs, according to a new analysis.
Over a recent three-month period, the cost of treating unvaccinated COVID-19 patients around the U.S. amounted to $5.7 billion, the report from the Kaiser Family Foundation and Peterson Center on Healthcare concluded. Drawing on hospital admissions and public health data, the groups based that estimate on the roughly 287,000 hospitalizations among unvaccinated people between June and August. They assumed the cost of their care at $20,000 per person, citing Centers for Medicare and Medicaid Services data and other research.
KFF-Peterson also factored in the effectiveness of vaccines in preventing severe illness and hospitalization, as well as the occurrence of so-called breakthrough infections in fully vaccinated people. The number of preventable hospitalizations was tallied by identifying unvaccinated adults who were hospitalized primarily because of COVID-19. The study does not seek to account for outpatient costs.
"This ballpark figure is likely an understatement of the cost burden from preventable treatment of COVID-19 among unvaccinated adults," the authors wrote. The overall financial costs of treating the unvaccinated are "borne not only by patients but also by society more broadly, including taxpayer-funded public programs and private insurance premiums paid by workers, businesses and individual purchasers," they added.
Patients hospitalized for COVID-19 don't typically pay for the entire cost of treatment. Instead, most people rely on private insurers and programs like Medicare and Medicaid to cover medical expenses.
The cost of lengthy hospital stays could have been avoided given that most adults in the U.S. have had access to effective vaccines since last spring, according to KFF-Peterson, which collaborate to track the quality and cost of health care. Studies show the COVID-19 vaccines are highly effective at keeping patients out of the hospital.
Insurance companies are increasingly shifting part of the cost burden of treating COVID-19 to unvaccinated people, a separate KFF analysis shows. In the early days of the pandemic, when no vaccine existed, most private insurers waived cost-sharing for patients under their plans or even covered the full cost of treatment for COVID-19.
As of November 2020, nearly 90% of insured individuals would have had their out-of-pocket costs — including copays, coinsurance or payments toward a deductible — waived if they had been hospitalized for COVID-19, according to KFF.
Now, with vaccines widely available, more than 70% of the nation's largest insurers are no longer waiving COVID-19 treatment costs, according to Kaiser, which surveyed the two largest insurers in each state and Washington, D.C.. Another 10% of plans plan to phase out cost-sharing by the end of October.