Hospitalizations for Unvaccinated Patients With COVID-19 Cost Billions

COVID-19 vaccines have been free and available to American adults in all states since April 2021. Despite this, as of early September 2021, 25% of adults over the age of 18 in the US remain unvaccinated. This has led to an increase in new cases, hospitalizations and deaths, according to a report from Peterson-KFF Health System Tracker.

This surge, which is largely preventable because the vaccines have been proven to be highly effective at preventing severe disease, hospitalization and death from COVID-19, is adding billions of dollars in preventable costs to the nation’s healthcare system.

According to the report, the average hospitalization cost of treating a patient with COVID is around $20,000. According to data from HHS and CDC, there were 32,000 preventable COVID hospitalizations in June, 68,000 in July, and an additional 187,000 in August for a total of 287,000.

Given this, new estimates of the preventable costs of treating unvaccinated patients in hospital total nearly $3.7 billion as of August, almost twice the estimates for June and July combined. From June to August, the total preventable cost reached nearly $5.7 billion.

Of note, the report points out, the monetary cost of treated unvaccinated people for COVID-19 falls not only on the patient but on society at large, including taxpayer-funded public programs and private insurance premiums paid by workers, businesses and individual purchasers.

In an analysis of privately insured patients who were hospitalized with pneumonia, the typical out-of-pocket payment was $1,300. This is, of course, relative to each individual’s insurance plan and would also depend on how COVID-19 hospitalization costs are billed. While this amount is significant for most patients to pay, it is far less than the amount covered by public and private insurance.

The report goes on to note that the Affordable Care Act and other laws prohibit insurers from charging unvaccinated people higher premiums. However, through wellness programs, employers have the ability to impose higher costs. Private insurers have begun reinstating cost-sharing for COVID-19 hospitalizations. The federal government requires insurers to cover the cost of COVID-19 tests without cost sharing for individualized diagnosis purposes, but insurers are not required to cover the cost of COVID-19 testing for employment purposes.

Unvaccinated workers may be required to get COVID-19 tests regularly to return to work physically, and insurers have the ability to, and may shift some or all costs for those tests to the workers. However, adults can largely avoid these out-of-pocket costs and severe illness by getting the free vaccine.