Updated at 4:40 p.m., Wednesday, Dec. 2, 2021. 

Dec. 2, 2021 -- Private insurers will soon be required to reimburse people enrolled in their plans for the cost of at-home, rapid COVID-19 tests, and mask mandates will be extended for air, rail, and bus travelers through at least mid-March.

The measures are part of a series of actions President Joe Biden announced Thursday in the wake of the arrival of the Omicron variant in the U.S. The White House’s initiatives are designed to fight an expected winter surge of COVID-19 infections.

“My plan I’m announcing today pulls no punches in the fight against COVID-19,” Biden said.

“Now as we move into the winter and face the challenge of this new variant, this is a moment we can put the divisiveness behind us, I hope,” he said. 

Biden added he hoped the nation would finally come together and unite in a common purpose: to fight the virus.

One of the biggest changes Biden announced was that he was going to make rapid COVID-19 tests available to Americans at no net cost.

At about $24 per box, rapid COVID-19 testing remains prohibitively expensive for many, even after a promise to bring the tests to Americans at a wholesale cost.

Other countries have rapid tests available for free or about $1 per test, and many experts say more frequent use of rapid tests could help stop transmission of COVID-19 virus.

About 150 million Americans would be eligible for coverage of rapid tests through their insurance plans.

While many public health experts praised the goal of increasing the availability and use of rapid tests in the U.S., some said they weren’t sure that asking people to file for reimbursement was the best way to accomplish it.

“For this next phase of the pandemic, rapid access to rapid testing will be key,” said Nirav Shah, MD, JD, who directs the Maine Center for Disease Control and Prevention and is president of the Association of State and Territorial Health Officials. 

Shah said more rapid tests could help the U.S. contend with potential surges driven by new variants, like Omicron, and they will also be critical to help people get timely access to new antiviral pills that work best when taken within the first few days of infection. 

Then there are the new federal vaccine mandates for workers -- some of which are being delayed in courts --  that allow people who can’t or won’t get vaccinated the option of coming to work as long as they pass a COVID-19 test, an accommodation that will almost certainly increase demand for the tests in the coming months.

There will also be new “test-to-stay” policies in schools that allows students who have been exposed to stay in class as long as they wear a mask and continue to test negative.

“We need to make sure the supply is there to meet that forthcoming demand,” Shah said.

He said some states were still having issues getting enough rapid tests and said the supply issues would need to be resolved for testing to have an impact.

Others had questions about how insurance coverage for over-the-counter tests would work.  Administration officials said Americans would be reimbursed for their spending on rapid tests, something many flagged as less than ideal.

“The reimbursement plan does nothing to help the McDonald’s worker, Uber driver, or meat-packing plant employee with rapid test access, and those people are the most at need of easy ways to monitor their COVID status,” said Ellie Murray, ScD, an epidemiologist at the Boston University School of Public Health.

“Reimbursement requires people floating the costs for a while and that is also potentially a big barrier,” Murray said.

To help people who are not privately insured, Biden pledged to distribute 50 million free tests to community health sites and rural clinics to reach some of the poorest and hardest hit areas of the country.

In addition to those steps, international travelers flying into the U.S. will soon be required to show proof of a negative COVID-19 test within 24 hours of their departure, whether they are vaccinated or not.

Carlos del Rio, MD, president-elect of the Infectious Diseases Society of America’s Board of Directors, said he was happy to see the testing requirements for travelers but hoped the travel bans would soon be dropped.

"I think travel restrictions don't work for respiratory viruses. They have never worked,” he said. “They're not scientifically sound, but testing is scientifically sound,” del Rio added.

“I personally, as an individual when I travel on a plane, I test myself 24 to 48 hours before I travel, and I test myself to 3 days after I land. It's a very effective way of knowing if you've been exposed and then, you know, preventing transmitting to others," he said.

In keeping with the six-part plan to fight COVID-19 the administration outlined in August, the president’s new winter plan is centered on vaccinations for all eligible Americans, including booster doses for the estimated 100 million adults who are now at least 6 months past their second doses of a Pfizer or Moderna vaccine or 2 months past a Johnson & Johnson shot.

Those plans, which relied on vaccine mandates for most workers, have been stymied by recent court rulings blocking implementation of those requirements.

As the issue makes its way through the courts, Biden is expected to continue to call on companies to voluntarily implement vaccination requirements for their workers, which he says are helping to close vaccination gaps.

On Thursday, Biden promised a new push to get booster shots to all adults, with an emphasis on reaching seniors, who are at greatest risk for hospitalization and death from COVID-19.

He also promised to set up family vaccination clinics so parents and kids could get their shots at the same time.

And critical to states that are suffering working shortages, Biden promised to send federal teams to states to ease some of that pain.

“Staffing at the state level has remained a challenge. We’re delighted to see the president free up additional state assets that can assist with that,” Shah said.

Show Sources

White House press briefing, Dec. 2, 2021.

Nirav Shah, MD, JD,  director, Maine Center for Disease Control and Prevention; president, Association of State and Territorial Health Officials.

Ellie Murray, ScD, epidemiologist, assistant professor, Boston University School of Public Health, Massachusetts.

Carlos del Rio, MD, executive associate dean, Emory School of Medicine, Atlanta, GA.

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