Covid-19 Emergencies Ending

Biden to end Covid emergencies

President Biden told Congress on Monday that he will end the national emergencies to combat the coronavirus outbreak on May 11.

House Republicans had been threatening legislation to end the emergency declarations immediately.

The White House said, “An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the healthcare system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans.”

Continuing the emergency declaration until May 11^th will allow hospitals and nursing homes time to retrain staff and establish new billing processes.

What happens after May 11?

Benefits disappearing

The federal government has been providing free Covid-19 tests, treatments and vaccines. People will have to start paying for some.

Most Americans covered by Medicare, Medicaid and private insurance plans have been able to obtain Covid-19 tests and vaccines at no cost during the pandemic.

♦ Once the emergency ends, Medicare beneficiaries will face out-of-pocket costs for at-home testing and all treatment. However, vaccines will continue to be covered at no cost, as will testing ordered by a healthcare provider.

State Medicaid programs will have to continue covering Covid-19 tests ordered by a physician and vaccines at no charge. But enrollees may face out-of-pocket costs for treatments.

• Individuals with private insurance could face charges for lab tests, even if they are ordered by a provider. Vaccinations will continue to be free for those with private insurance who go to in-network providers, but going to an out-of-network providers could incur charges.

♦ Covid-19 vaccinations will be free for those with insurance even when the public health emergency ends.

People with private insurance have not been charged for monoclonal antibody treatment since they were prepaid by the federal government, though patients may be charged for the office visit or administration of the treatment.

• Antibody treatment is not tied to the public health emergency, and the free treatments will be available until the federal supply is exhausted.

The government has already run out of some of the treatments so those with private insurance may already be picking up some of the cost.

• The uninsured had been able to access no-cost testing, treatments and vaccines through a different pandemic relief program. However, the federal funding ran out in the spring of 2022.

♦ The uninsured and underinsured have no guaranteed access to Covid vaccines, tests or treatments.

Congress has not authorized additional funding to purchase additional vaccines, treatments and tests. Covid-19 care shifts now to the commercial market.

Pfizer and Moderna have already announced that the prices of their Covid-19 vaccines will likely be between $82 and $130 per dose – about three to four times what the federal government has paid.

Medicare provisions

The public health emergency has also meant additional funds for hospitals, which have been receiving a 20% increase in Medicare’s payment rate for treating Covid-19 patients.

Medicare Advantage plans have been required to bill enrollees affected by the emergency and receiving care at out-of-network facilities the same as if they were at in-network facilities.

These benefits will end once the public health emergency expires.

Less impacted

Several pandemic public assistance programs are no longer tied to the health emergency declaration.

♦ Most notably, states will now be able to start processing Medicaid redeterminations and kicking people off Medicaid, starting Aril 1^st. States have 14 months to review the eligibility of their beneficiaries.

As part of a Covid-19 relief package passed in March 2020, states were barred from kicking people off Medicaid during the public health emergency in exchange for additional federal matching funds.

• That protection will end and millions are expected to lose coverage.

The Department of Health and Human Services (HHS) estimates that roughly 15 million people could be dropped from Medicaid.

About 8.2 million people would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the HHS estimates.

Food stamps

Food stamp recipients had been receiving a boost during the public health emergency. Congress increased food stamp benefits to the maximum for their family size in a 2020 pandemic relief package.

The Biden administration increased the boost in the spring of 2021 so that households already receiving the maximum amount and those who received only a small monthly benefit get a supplement of at least $95 a month.

The Consolidated Appropriations Act was passed at the end of 2022. It ends emergency assistance after the February 2023 issuance.

This extra assistance will end as of March, though several states have already stopped providing it.

Emergency assistance ended last year in Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Missouri, Montana, Nebraska, North Dakota, South Dakota, Tennessee and Wyoming.

Congressional action

In anticipation of the ending of the public health emergency, Congress has already taken action to ease some of the impact of the move.

• Congress extended telehealth benefits through 2024. This is especially helpful to people living in rural areas.

More Medicare enrollees were able to get care via telehealth during the public health emergency. They can conduct a telehealth visit at home, rather than having to travel to a health care facility. Plus, beneficiaries can use smartphones and receive a wider array of services via telehealth.

• Congress also agreed to allow Medicare to cover oral antiviral drugs like Paxlovid™.

Medicare will now be allowed to cover oral antiviral drugs even if they are under an emergency use authorization. This continues through the end of 2024.

The Biden administration says it is actively reviewing flexible policies that were authorized under the public health emergency to determine which can remain in place after the emergency declaration it is lifted on May 11^th.