People who do not have health insurance may now be charged for COVID-19 testing, treatment and vaccination depending on where they seek those services.

Federal funding from the federal Health Resources and Services Administration that paid for COVID-19 testing and treatment for people without health insurance has dried up. Next week, HRSA funds for vaccines for people without health insurance also will cease.

The change means that some hospitals, clinics and labs that have been offering COVID-19 services for free to people without insurance will begin charging.

Not all options for free testing and vaccines are going away, however.

Thanks to other federal funding sources and Washington state agency grant programs, free COVID-19 testing and vaccinations still will be available to all Washingtonians going forward.

There are an estimated 465,000 people in Washington who do not have health insurance, and lawmakers in Washington have paved the way for this to change in the coming years.

During the pandemic, in Spokane and Spokane Valley alone, labs, hospitals, clinics and health care providers sought more than $7.2 million in reimbursement from HRSA for providing COVID-19 testing, treatment and vaccinations to people without health insurance, according to data from the Centers for Disease Control and Prevention.

Providence provided $3.2 million in testing, treatment and vaccines to uninsured people in Spokane and Spokane Valley, CDC data show. MultiCare provided $1.2 million in testing, treatment and vaccines to uninsured people in Spokane and Spokane Valley.

Both hospital systems have financial assistance programs that were in place before the pandemic and will continue despite the change in federal funding.

“If a patient doesn’t have insurance, we will work with them to identify possible insurance options and assess their eligibility for our financial assistance program,” MultiCare spokesperson Kevin Maloney said in an email. “We encourage community members to check with their local health departments for testing and vaccination locations.”

Incyte Diagnostics, which processes COVID-19 tests at its labs, received $1.6 million for treatment and testing for uninsured individuals, CDC data show.

Now, public health agencies and federally qualified health centers likely will have to fill the gap to provide COVID-19 testing and vaccines without charge to people without health insurance.

When HRSA announced the federal funding was not getting replenished, state agencies had days to react.

At Washington’s Health Care Authority, a separate program authorized by the Legislature could play a timely role in filling the gap for providers.

The Uninsured Care Expansion Grant program was planned before the agency knew HRSA funding would cease. Now, federally qualified health centers, rural clinics, public hospital districts and community-based organizations can apply for these grants to help offer services to those without health insurance.

The Health Care Authority created the grant program with $35 million in federal funding to help cover uninsured individuals at or below 200% of the federal poverty level. Eligible health care providers can apply for the grant program until April 15.

State health officials at the Washington Department of Health praised the grant program for its potential to fill in the gaps.

Deputy Secretary Lacy Fehrenbach encouraged Washington residents without health insurance to try to get covered if possible.

“If you remain uninsured, there are still options available,” Fehrenbach said Wednesday, adding that many state and local COVID-19 testing and vaccine clinics will remain open to everyone.

In Spokane County, community testing sites are funded with Federal Emergency Management Agency money, which covers anyone who seeks testing regardless of their insured status.

FEMA funding for COVID-19 response efforts is not ending, and it will cover 100% of eligible expenses through July 1, Spokane Regional Health District spokesperson Kelli Hawkins said in an email. Even after that date, reimbursement is expected to continue at 90% from FEMA.

Additionally, vaccine clinics offered by the Spokane Regional Health District or the Department of Health Care-A-Vans are also free for everyone regardless of insured status.

Hawkins confirmed that vaccine clinic funds also are not impacted by HRSA funding running out.