The US agreed to spend at least $6 billion last year to mail millions of at-home Covid-19 tests, but the Biden administration won’t share the price per test, where they were sent, or details showing whether they reached the neediest Americans.
White House staff, the US Postal Service, and other agencies declined multiple Bloomberg Government requests for information on the program for nearly a year.
State and local health officials also don’t know who received Biden’s test kits. The lack of information made it harder to determine which communities got tests and where they should distribute their own, state or local officials in three states said.
The US has delivered 737 million tests to homes by mail since January 2022, said Zachary Dembner, spokesman for the Department of Health and Human Services. Dembner said 41% were sent to neighborhoods with especially vulnerable residents—based on zip code data that typically weighs socioeconomic status, demographics, and access to housing and transportation. Neither he nor staff from other involved agencies would disclose the data or formula to support that assessment.
The Biden administration this week announced plans to end the coronavirus public health emergency that helped pay for the nation’s pandemic response over the past three years. The sparse details on the test-kit distribution highlight what some say has been a consistent lack of transparency and accountability over that response.
“There are millions of dollars going out the door on programs [where] we have very little data,” said Joanna Derman of the Project on Government Oversight, a nonpartisan group that investigates government waste. “It’s not just size, it’s the speed of the money that goes out the door. That calls for increased oversight.”
‘Not Where We Should Be’
The free test kits were just one part of the administration’s broader array of testing options. Biden’s March 2021 stimulus law (
When the country saw a spike in omicron variant infections later that year, the president pledged to send out 1 billion rapid tests to homes.
“We need more testing,” Biden told reporters at the White House. “And on that score, we are not where we should be.”
Months later, his top Covid-19 adviser stressed that distributing tests equitably was critical.
“We’ve thought a lot about equity in this case…” Dr. Ashish Jha told reporters in June. “We’ve distributed tests to food banks. We’ve distributed tests to Federally Qualified Health Centers. We have a whole series of efforts ... to make sure that the testing is getting out through a variety of different channels so that people who may not normally be able to access it in other contexts can get access to tests.”
The administration set up a website and phone line where anyone could register to receive test kits by mail. While employee benefits covered rapid tests for many Americans, as many as 28 million don’t have health insurance.
The Postal Service later established dozens of fulfillment centers nationwide to handle millions of pallets of tests, Pritha Mehra, the Postal Service’s chief information officer, said in a presentation last summer. Thousands of seasonal workers agreed to stay on after the holidays to pack, label, and ship the kits to homes nationwide.
The military allocated $4.5 billion for the tests from at least 10 companies, according to contract summaries through June 2022 reviewed by Bloomberg Government. Another $1.6 billion was allocated for the test-kit distribution just through early February 2022, according to figures the administration reported to Congress.
Military and health officials said they didn’t have records for the agreements, and the White House declined to provide copies of most of its contracts with test suppliers.
The Department of Health and Human Services posted two contracts—those with medical supply companies Medea Inc. and Atlantic Trading LLC—but with redactions. In both, the cost of each test was hidden and labeled as a trade secret. Companies supplying the US with tests asked Biden officials not to disclose the price, said Jessica Maxwell, a spokeswoman for the Pentagon.
Military officials often decline to share prices, sometimes because their agreements with companies prohibit it. The cost per test also depends on the contract’s details, such as whether shipping is included, said Marie Mak, director of federal contracts at the Government Accountability Office, the congressional agency that audits spending.
Medea and Atlantic Trading did not respond to Bloomberg Government requests for more details.
The United Kingdom set up a similar option for residents to order free tests. Officials there also declined to say how much they spent per test because it is “commercially sensitive material,” said James Wood, spokesperson for the UK Health Security Agency.
‘Duplicate Efforts’
As infections and hospitalizations for Covid-19 continue to fall, Americans are mostly skipping tests these days, along with other pandemic precautions. Just a third of Americans see contracting the virus as a large or moderate risk, according to an Axios-Ipsos survey taken in early December.
The administration did track where the tests went for at least part of the time. Biden’s team tallied recipients by zip codes in the spring of 2022, said Tom Inglesby, Biden’s former Covid-19 testing coordinator and a health researcher at Johns Hopkins University.
Early results showed the tests reached the most impoverished neighborhoods and places with large groups of Black or Latino residents, Inglesby said. He left the administration last summer.
Knowing where and how many rapid tests have been shipped is especially useful for protecting Americans living outside metro areas, said Kendra Babitz, Utah’s coronavirus testing coordinator.
Rural residents often need to drive long distances to reach a test site. Knowing which areas got, or didn’t get, free at-home tests from the Biden administration would make it easier to decide where to establish state-run testing options, she said. The state’s governor had asked most residents in January 2022 to skip testing in an effort to conserve supplies.
“We really didn’t have any insight or transparency into that program and where the tests were going,” Babitz said.
In California, such data was especially important because the state had limited testing supplies during last winter’s omicron surge, said Erica Pan, California’s state epidemiologist.
The state bought millions of its own antigen tests using federal money after officials ran low on supplies from Washington, she said. City officials asked for her help figuring out where the federal mail-order tests were sent. Pan couldn’t answer that.
Lydia Isaac, a health equity researcher at National Urban League, said her team helped spread the word about the mail-order tests to underserved groups in dozens of states, though she didn’t follow up on whether they received them.
Not ‘Particularly Concerned’
Congress hasn’t directed government auditors to examine whether the Biden administration got a fair price for the mail-order tests or whether the tests equitably reached all Americans. Mak, GAO’s lead contracts auditor, said her office typically inspects programs when a law requires it or if a high-ranking member of Congress asks for an audit, but that no one has.
That signals that Congress isn’t “particularly concerned” about the mail-order testing initiative, said Linda Miller, former deputy director of the government auditors tasked with reviewing pandemic spending. That committee–formed to track how the US spends $5 trillion in relief funds–had urged US officials in November 2020 to improve its record-keeping.
The Postal Service’s own auditor published a report in September on its role in the Covid test mail-order effort. Its recommendations included that the agency’s management strengthen how it tracks costs and revenue and improve its software in case of emergencies.
The same report redacted how much the agency spent distributing the tests and mistakes the carrier made delivering them.
A spokesman for the auditor declined to explain why.
Disclaimer: The Johns Hopkins Bloomberg School of Public Health is supported by Michael Bloomberg. Michael Bloomberg is the majority owner of Bloomberg Government’s parent company.
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