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After more than three years, the U.S. COVID-19 public health emergency ended on Thursday, May 11.
Earlier this year, the White House announced that it would end the emergency as COVID-19 hospitalizations and deaths have been at their lowest levels since March 2020. Based on a fact sheet issued by the Department of Health and Human Services (HHS), many Americans likely won’t notice the emergency is ending as it primarily impacted Medicare waivers and related services, coverage for COVID-19 testing, virus surveillance, and changes to the Public Readiness and Emergency Preparedness (PREP) Act.
“Our whole-of-government response to Long COVID will not change,” said HHS in a fact sheet earlier this week, referring to what some medical professionals say are lingering, long-term symptoms of COVID-19. “The Department has and will continue to coordinate a whole-of-government response to the longer-term effects of COVID-19, including Long COVID and associated conditions. On April 5, HHS released this Fact Sheet outlining the progress made in responding to Long COVID and actions the Department is taking to address the needs of the growing population with Long COVID and associated conditions.”
It also said that “major telehealth flexibilities,” too, won’t be impacted by the end of the order. That means Medicare-backed provisions for telehealth meetings and prescriptions will still remain intact until December 2024, and “states already have significant flexibility with respect to covering and paying for Medicaid services delivered via telehealth,” according to the sheet.
Perhaps most notably, the U.S. Food and Drug Administration (FDA) will still have the ability to hand down emergency use authorizations for COVID-19 products, vaccines, and treatments. The agency’s decisions to use emergency use authorizations to approve certain COVID-19 vaccines has been controversial, as some independent health experts and researchers have said that not enough data on possible side effects were obtained before the FDA approved the shots.
A number of Medicare and Medicaid recipients will be impacted by the ending of the emergency, the HHS fact sheet suggested. The agency that manages the two federal programs used a combination of waivers, regulations, guidance, and other means to expand access to the programs amid the COVID-19 pandemic.
“States, hospitals, nursing homes, and others are currently operating under hundreds of these waivers that affect care delivery and payment and that are integrated into patient care and provider systems. Many of these waivers and flexibilities were necessary to expand facility capacity for the health care system and to allow the health care system to weather the heightened strain created by COVID-19; given the current state of COVID-19, this excess capacity is no longer necessary,” said the agency.
With COVID-19, Medicaid grew to be larger than it’s ever been as about 95 million beneficiaries are estimated to fall under its coverage. Under a congressional provision, states could begin disenrolling people from the federal program as of April 1.
There have been studies and reports suggesting that as many as 15 million people may lose Medicaid coverage in the coming months as states work to update their rolls.
Some COVID-19 waivers for Medicaid will end on May 11, said HHS, adding that others will remain intact for another six months. However, a number of states may still offer waivers and flexibilities beyond the end of the public emergency at their choosing.
Certain COVID-19 data and surveillance will also change, officials said. With the end of the emergency, HHS won’t have the “express authority” to require lab test reporting for COVID-19 that will affect positivity tests in some locations. Hospital data reporting will persist until April 30, 2024, it said.
CDC Director Dr. Rochelle Walensky, who will step down soon, told Congress that the agency needs to negotiate data-sharing agreements with jurisdictions.
“This should worry us all primarily because what it says about the visibility we will have into the next outbreak,” Walensky told the Senate health committee several days ago. “We will be back to square one having to build and negotiate surveillance capacity while we fight a pathogen.”
As for vaccines, they will continue to be free. The U.S. government has purchased all of the current supply and is providing it at no charge, but it will not buy any more doses starting from now. People who have health insurance will also likely get them for free after the supply runs out, according to CNN and NPR.
The public health emergency was implemented by former President Donald Trump’s administration in early 2020 when a small number of COVID-19 case numbers were confirmed across the United States.
“Beginning at 5:00 p.m. EST Sunday, February the 2nd, the United States government will implement temporary measures to increase our abilities to detect and contain the coronavirus proactively and aggressively,” said then-Health and Human Services Secretary Alex Azar in a news briefing on Jan. 31, 2020.
In recent months before the White House’s announcement, both Republican and Democrat lawmakers sought to put an end to the emergency. In March, the Senate voted to overturn the emergency provision with bipartisan support.
Last week, the World Health Organization declared an end to the global COVID-19 emergency. WHO chief Tedros Adhanom Ghebreyesus, however, warned governments around the world to not dismantle the systems that were created to respond to the coronavirus.
“This virus is here to stay. It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths,” Tedros told reporters.
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