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Health insurance premiums, especially in the ACA Marketplace, could increase if the federal government ends purchasing of COVID-19 vaccines and boosters.
If the federal government stops covering the costs of COVID-19 vaccinations, the total cost for purchasing booster shots commercially would be between $6.2 billion and $29.7 billion a year, according to new analysis from the Kaiser Family Foundation. (See table below for KFF analysis of three scenarios.) These costs are likely to be covered by both public and private vaccine payers, and could lead to premium increases, finds KFF.
To date, the federal government has spent more than $30 billion on COVID-19 vaccines to ensure that the public can access them at no charge. Pfizer and Moderna have announced that the anticipated commercial price per dose of their vaccines would likely be between $82 and $130 per dose – roughly three to four times what the federal government has paid, according to the KFF analysis.
Analysts with KFF compared the average price paid by the federal government for the COVID-19 bivalent boosters to the estimated average commercial prices that have been suggested by manufacturers. They calculated an overall cost for purchasing vaccines for the adult population across different scenarios of vaccine uptake. They focused on Pfizer and Moderna vaccines, which account for almost all doses administered in the United States (97% as of Nov. 30, 2022).
In total, the federal government has made six different bulk purchases from Pfizer, totaling 655 million doses at $19.50 per dose, and five bulk purchases from Moderna, totaling 566 million doses $15.25 per dose. Other purchases were made at a higher price per dose, with a weighted average across of $20.69.
The price paid per dose increased over time, with the highest prices paid for the bivalent boosters, including 105 million doses at $30.48 per dose from Pfizer and 66 million doses at $26.36 per dose from Moderna. in total, the United States has purchased 171 million doses of the bivalent booster at a cost of $4.9 billion.
KFF analysts expect that most of the costs will be covered by Medicare because older adults are more likely to receive booster shots. Health insurance premiums, especially in the ACA Marketplace, could increase if the federal government ends purchasing of COVID-10 vaccines and boosters. For the uninsured, cost could be a barrier.
Analysts stressed their analysis focused on the cost of a purchasing a single vaccine dose in different scenarios, but it’s possible that doses could be needed more frequently if new variants arrive. Costs will also depend on the number of people who chose to vaccinated.