On the CDC’s website, the agency clearly states: “The federal government is providing the [COVID] vaccine free of charge to all people living in the United States, regardless of their immigration or health insurance status.” They warn that no one can be charged for the COVID vaccine, including “any administration fees, copays, or coinsurance,” and that providers cannot “deny vaccination to anyone who does not have health insurance coverage, is underinsured, or is out of network.” However, they note, “COVID-19 vaccination providers can seek appropriate reimbursement from the recipient’s plan or program (e.g., private health insurance, Medicare, Medicaid) for a vaccine administration fee.” For those without insurance, the Health Resources and Services Administration Provider Relief Fund is picking up the cost of vaccinations. But, Walensky said, unfortunately, this could all change. For more on what to expect from your jab, check out This Is What It Means If You Have No Vaccine Side Effects, Doctors Say. During the discussion with moderator Shefali Luthra, healthcare reporter with The 19th, Walensky pointed out that, by its very nature as a seasonal, respiratory virus that mutates, COVID-19 will continue to generate costs long into the future. “I worry about the day where the vaccine will no longer be free,” she said. “What about all those people? What about if we need a third booster? What happens then? Who’s going to pay for that?” Unfortunately, there are not yet answers to those big questions. While the initial vaccinations—two doses of Moderna and Pfizer, or one dose of Johnson & Johnson–will be covered by the government, it’s highly likely that you’ll need further vaccinations against COVID. Firstly, due to the new strains and mutations that have emerged since the vaccines were created, pharmaceutical companies are working on booster shots to combat those variants, as Walensky alluded. Secondly, Pfizer CEO Albert Bourla recently told NBC News that COVID shots are likely to become an annual occurrence. “Every year, you need to go to get your flu vaccine,” Bourla said in late February. “It’s going to be the same with COVID. In a year, you will have to go and get your annual shot for COVID to be protected.” And for more on preparing for your shot, check out Don’t Do This the Night Before Your Vaccine Appointment, Experts Say. “I think this pandemic is going to change a lot of how we think about the cost of healthcare, about access to healthcare,” Walensky said. But she was upfront about the scale of the challenge and the lack of simple answers when reckoning with the cost of COVID. “I think I would be way out over my skis if I started talking about exactly what healthcare reform looks like,” she told Luthra. “I think we need public health reform, I think we need so many things.” There is a clear public appetite for this as well. A ValuePenguin healthcare survey in Jan. 2021 estimated that nearly 3 in 10 Americans lost their health insurance coverage in 2020 and remain uninsured into this year. Nearly half of respondents—47 percent—had lost their health coverage when they were laid off or furloughed from their jobs as a consequence of the pandemic. The survey also found that 42 percent of those without coverage said they didn’t have the money to afford premiums. The burden was falling more heavily on women, with 51 percent versus 34 percent of men saying they could afford to pay for their policy. And for more COVID news delivered right to your inbox, sign up for our daily newsletter. Experts have also been warning about the strain that the cost of COVID “long-haulers” will place on the medical system as patients suffering from post-viral conditions require long-term, complex care. According to a report published in The Guardian, “at least 10 percent of people reportedly infected with COVID-19 have gone on to develop long-haulers syndrome.” With the CDC estimating current total case numbers at just over 29 million and growing, this is potentially at least 3 million people likely to require long-term care in the U.S. as a direct result of COVID.ae0fcc31ae342fd3a1346ebb1f342fcb “I think there are an extraordinary number of questions that are going to be associated with how this pandemic is going to be paid for, how the future of healthcare is going to be paid for, how the future of public health is going to be paid for,” Walensky said. However, in her closing remarks, she also expressed the opportunity we have to learn from past mistakes and reinvent the system in a more efficient way. “Because we are a product of the fact that we didn’t invest in [public health]… I think all of those things are going to have to be on the table moving forward,” she said. And for more on the latest in the battle against COVID, check out Dr. Fauci Says These Are the COVID Symptoms That Don’t Go Away.