Reason Roundup

Biden's Plan To Make At-Home COVID-19 Tests More Expensive and Harder To Find

Plus: Waiting lists for public defenders, inflation boogeymen, and more...

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zumaamericasthirtythree397300 | Jill Connelly/ZUMAPRESS/Newscom
(Jill Connelly/ZUMAPRESS/Newscom)

Seriously? With a new plan for at-home COVID-19 testing, the U.S. continues to embrace the most convoluted and costly approach to health care. On Monday, the Biden administration announced that health insurance plans must cover at least eight at-home tests per member per month.

In some countries, COVID-19 test approval has been swift and many companies have been allowed to make tests, spurring robust competition and driving down prices while ensuring there are plenty of tests to go around. Other countries have made free tests available directly from government sources—a plan not exactly desirable from a fiscal or free market standpoint, but at least theoretically capable of making sure people actually have access to tests.

In contrast, the U.S. has chosen the worst of all worlds, in effect making COVID-19 tests both limited and expensive. While at-home rapid tests in many countries are plentiful and cost as little as a few dollars per test, here they remain hard to find and about $24 or more for a two-pack. Why? Because our government was slow, overcautious, and obscenely selective when approving tests for market, making companies jump through complicated and costly hoops to be allowed to sell tests here and thus ensuring that those allowed are expensive and scarce. The U.S. has faced serious issues with testing since the start of the pandemic and—two years in—demand for tests continues to drastically outpace supply.

The best way to solve this would be for the Food and Drug Administration to start approving more tests, including those made in the U.S. and those imported from elsewhere, while swiftly working to resolve any quality concerns with those that don't quite make the cut. More tests means not only more tests (a critical first step) but lower-cost tests, too, as manufacturers face a more crowded marketplace.

Instead, the administration is getting insurance companies more involved—basically, the number one way to drive up health care costs. When insurance companies must cover tests then the true costs are hidden from most consumers, disincentivizing manufactures from making sure their tests are affordable. In many cases, involving insurance actually leads to raised costs.

So, sure, the upfront cost of tests might go down for consumers with health insurance (though of course, the more "free" services are mandated, the more the overall price of health insurance goes up). But tests will remain expensive for the many, many Americans who don't have insurance—a group that's likely more price-sensitive than those who do.

Upfront testing costs could also remain prohibitive for those whose insurance companies will only reimburse them for tests after they purchase them and fill out the requisite paperwork. Plus, the price of testing will stay high for organizations, venues, and events providing tests for staff, attendees, etc.

All of this limits the likelihood of more widespread testing and the benefits it could bring.

And that's not the only snag with the Biden administration's new plan for tests. If folks with insurance are allowed to obtain eight "free" tests per month, many will be inclined to snag those tests even if they don't currently need them. And a subset of people stockpiling tests when they're still in short supply could lead to an even greater test shortage, making it even harder than it is now for many who need tests to find them.

"If reimbursement exists but there aren't tests to purchase" then "that doesn't help an individual consumer," as Lindsey Dawson, an associate director at the Kaiser Family Foundation, told The New York Times. "The policy could certainly drive demand, and could exacerbate the problem."

FREE MINDS

Court mulls waiting list for public defenders. A Missouri state official said "there is no longer a waiting list for criminal defendants to be represented by an attorney in Missouri," reports The Kansas City Star. Groups including the American Civil Liberties Union (ACLU) had sued over the waiting list and, last February, Judge William E. Hickle issued a temporary stay, writing that the waiting list "violates the obligations of the State to furnish counsel to allow for adequate representation at critical stages and at trial."

The state now argues that the lawsuit should be dismissed, since the waiting list is gone. However,

Anthony Rothert with the ACLU argued that while wait lists might temporarily not be necessary, they have not been eradicated. He said that while the public defender's budget has increased, it is subject to re-appropriation year after year. They are seeking a final judgment declaring that the use of wait lists is unconstitutional.

FREE MARKETS

Root of inflation divides the Biden administration. The Biden crew's attempt to scapegoat big companies for inflation has drawn some criticism from within the administration's own ranks, The Washington Post reports:

Senior officials at the Treasury Department, for instance, have been unsettled by the White House's attempts to blame some large corporations for inflation, skeptical of that explanation for the recent rise in prices, according to four people with knowledge of internal administration dynamics.…

"There are some people at Treasury, all the way to the top, that have a very strong analytical bent and recognize there is something to the notion that the lack of contestability in certain markets has driven up prices, but also think that it's hard to imagine that's a significant factor in the current surge," said Eswar Prasad, an economist at Cornell University and former senior official at the International Monetary Fund. "There is unease at Treasury about pushing this line too hard," he added. "There is a real concern there about this going too far."

Some Treasury officials say relaxing tariffs instituted by the Trump administration and continued under President Joe Biden would do more good than more antitrust antics. Alas, corporations have emerged as a politically useful place to lay blame.

"When inflation first emerged as a potential threat in the spring of 2021, many Biden administration officials characterized it as temporary and unlikely to persist," notes the Post. But:

The White House was forced to reverse course over the summer and fall as price hikes — initially confined to a few sectors particularly affected by the coronavirus — spread to hit the rest of the economy more broadly.

As the president's economic approval ratings slipped, his aides fielded increasingly alarmed messages from Democratic operatives urging the White House to adopt a new message on inflation. In November and December, at least four Democratic polling experts told senior White House officials that they needed to find a new approach as public frustration over price hikes became widespread and highly damaging to Biden's popularity, according to three people with knowledge of the private conversations.

"What we said is, 'You need a villain or an explanation for this. If you don't provide one, voters will fill one in. The right is providing an explanation, which is that you're spending too much,'" one Democratic pollster who, like the others, spoke on the condition of anonymity to reflect private conversations, told The Washington Post. "That point finally became convincing to people in the White House."

In related news, the congressional fight over antitrust law isn't going away anytime soon.

QUICK HITS

• A new report from the Cato Institute looks at levels of freedom across the United States, ranking individual states on whether they're more or less free. States are ranked along several dimensions of freedom, including fiscal policy, regulatory policy, and personal freedom. The 10 most free states (in order, starting from most free) are New Hampshire, Florida, Nevada, Tennessee, South Dakota, Indiana, Michigan, Georgia, Arizona, and Idaho. The 10 least free states (in order, starting from least free) are New York, Hawaii, California, New Jersey, Oregon, Maryland, Delaware, Vermont, New Mexico, and Rhode Island.

• A good reminder that "remote learning" doesn't mean the same thing for all kids.

• "At a moment when too many media outlets see their role as working with the state to reinforce official narratives…the struggle isn't over the 'disinformation' and 'misinformation' called out by opportunistic politicians, it's over control of information," writes J.D. Tuccille. (Speaking of which…the governor of Washington has a new unconstitutional plan to address election misinformation.)

• Are we living through a "broad rise in aggressive and anti-social behavior"? Matthew Yglesias makes the case that we are, and that this explains a rise in everything from murders to school discipline issues to traffic deaths.

• "Some 2022 Democrats are sounding like 2020 Republicans" about COVID-19, notes Atlantic staff writer Derek Thompson.

• After last week's teachers union strike, Chicago schools will resume in-person instruction on Wednesday: