The COVID Public Health Emergency Is Ending. Here's What That Means for Health Care
First declared in January 2020, the emergency order will expire on May 11.
Federal funding for free COVID-19 vaccines will end when the public health emergency expires.
The public health emergency for COVID-19 is slated to end on May 11, close to three years after it was first declared by the Trump administration.
It's been extended more than a dozen times since and was originally scheduled to expire on April 11, but US President Joe Biden added another month to help with the transition.
"An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system -- for states, for hospitals and doctors' offices, and, most importantly, for tens of millions of Americans," the White House said in a statement.
Among other provisions, the order ensures federal funding for free COVID vaccines, testing and treatment, and relaxes requirements for Medicaid and Medicare coverage.
Here's what to know about the public health emergency, including what it does and what happens when it ends.
For more coronavirus info, find out what we know about long COVID and whether your expired COVID tests are still good.
What is a public health emergency?
Under the Public Health Service Act of 1944, the secretary of the Department of Health and Human Services has the authority to declare that a disease outbreak or bioterror attack poses a public health crisis for a period of 90 days at a time. After that, the declaration must be extended.
That determination allows the HHS, the Centers for Disease Control and Prevention and other government agencies to access additional funding and increase staffing "to prevent, prepare for, or respond to an infectious disease emergency."
It also waives certain requirements for Medicare, Medicaid and the Children's Health Insurance Program (CHIP) and relaxes restrictions on telemedicine.
Some 20 million people have enrolled in Medicaid since the start of the pandemic, according to the Kaiser Family Foundation, an increase of 30% over typical numbers.
What happens when the COVID public health emergency ends?
The cost of Paxlovid will no longer be covered by the federal government when the public health emergency expires.
When the declaration lapses, responsibility for COVID-19 vaccines, testing and treatment will technically shift to individuals and their health insurance companies.
Government funding for COVID programs has already declined, with the Biden administration's request for $22.5 billion in additional pandemic aid having gone unanswered by Congress. Federal funds providing free vaccines, testing and treatment to uninsured Americans dried up in the spring of 2022.
The retail price of Pfizer's two-dose COVID vaccine is expected to quadruple, from $30 per shot to between $110 and $130.
Paxlovid, which has been shown to be nearly 90% effective in reducing the risk of a severe COVID disease, will also no longer be free. A course of the drug currently costs the US government $530, according to Kaiser Health News, but that's at a bulk discount.
Pfizer, which manufactures Paxlovid, hasn't announced what the retail price will be.
Most vaccinations will continue to be covered for individuals with private insurance. But they, too, may have to pay for treatment once the federal supply of monoclonal antibody treatments runs out. There may also be a copay for lab work and costs associated with vaccinations from out-of-network providers.
Medicaid will continue to cover COVID vaccines and tests ordered by a physician, but treatments and at-home testing may come with an out-of-pocket expense.
Changes to Medicaid
While the public health emergency order was in effect, state health agencies were directed to keep individuals enrolled in Medicaid and the Children's Health Insurance Program regardless of changes to their eligibility status.
That continuous coverage ended on March 31.
During the epidemic, Medicaid enrollment grew by more than 30% to more than 84 million people, according to the Kaiser Family Foundation.
It could take up to a year to for states to finish unenrolling people, by which time the "unwinding" of continuous coverage could see as many as 15 million people lose coverage, the foundation reported.
While the majority will be removed because they make too much money, HSS estimates that 45% (6.8 million) will be dropped from Medicaid rolls even though they're still eligible due to administrative issues such as incomplete paperwork or an unreported change of address.
Casualties of this "administrative churning" have to reapply for Medicaid or CHIP.