Explainer: Understanding Changes as COVID-19 Public Health Emergency Ends in May 2023
The White House announced in January that the COVID-19 national and public health emergencies will end on May 11, 2023. The public health emergency (PHE) was initially declared in January 2020 and renewed every 90 days. The emergency declaration enabled rapid response to the pandemic. Specifically, it allowed the government flexibility in the administration of public and private health insurance, and rapid authorization of medical countermeasures, and it enabled agencies to adjust processes to ensure that patients could easily access testing and treatment.
Is the pandemic over?
The pandemic is not over. The US is still counting more than 500 deaths daily due to Covid-19. However, the deaths from Covid-19 have declined by over 80% since January 2022. While Covid-19 remains a concern, the situation no longer constitutes a public emergency. By announcing an end to the PHE in May 2023, the government has initiated a transition period during which the flexibilities enacted during the emergency can be assessed, adjusted, and integrated where needed as we return to normal.
What policies will change?
The emergency allowed people to access testing and some treatments for COVID-19 for free. Ending the PHE requires complex adjustments to existing systems, which will vary depending on the state of residence and type of health insurance.
While individuals must consult their insurance provider for specific advice on upcoming changes, broad concerns are addressed below:
COVID-19 Testing
During the PHE, most insured people had access to free COVID-19 tests. Uninsured people paid out of pocket or could access free tests from local health centers or free clinics. When the PHE ends, the cost of COVID-19 tests will likely increase for people with insurance.
At-home tests: Coverage for free at-home tests will not be guaranteed for individuals on private Medicare plans or private insurance after May 11. For those on traditional Medicare plans, coverage of at-home tests will cease on May 11.
Medicaid will continue to cover at-home testing until September 2024, after which the decision on coverage will be left to individual states. The federal government may continue to provide free at-home tests while supplies last.
Tests administered by a health professional: While the test may be covered by insurance, people can expect to see associated add-on costs for the doctor visit. There may also be limits set on the number of tests covered.
Access to Vaccines
As long as federally purchased vaccines remain available, COVID-19 vaccines will be free of charge. Anyone providing a federally purchased vaccine may not charge patients for them or deny provision based on insurance coverage or network status. This may change after the federal supply runs out.
Treatment for COVID-19
Most people on private insurance have faced cost sharing for hospitalization and/or outpatient treatment of COVID-19. The end of the emergency will largely impact those on Medicare, who may see increased cost-sharing in the coming months. Cost-sharing means paying out of pocket for the portion of a bill that is not covered by insurance. These measures include deductibles and copayments.
In 2022, the federal government purchased a large volume of the COVID-19 treatment, Paxlovid, which has helped prevent hospitalization or death for many people infected with COVID-19. Access to this treatment will remain free for as long as the federal supply lasts.
Changes to Telemedicine
During the emergency, rules around prescriptions were relaxed such that a telehealth consultation was deemed adequate to issue prescriptions. After May 11, patients may need to visit their healthcare provider in person to receive prescriptions for controlled substances.
Medicaid enrollment
During the pandemic, the government ensured that anyone in a Medicaid program would remain continuously enrolled until the PHE ended. This led to record-high enrollment in Medicaid, but disenrollment is scheduled to begin in April 2023. This could lead to a steep increase in uninsured people in the US.
What steps can we take to continue to protect our health?
The changes to policy and costs of COVID-19 testing and treatment are still underway. Individuals should consult with their insurance providers to determine personal impact.
As the public health emergency ends, it is important to remember that COVID-19 has not been eradicated. Rather than letting their guard down, people should continue to take precautions to avoid infection.
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References and Further Reading:
Centre for Disease Control and Prevention. Requirements for COVID-19 Vaccination Program Providers. Accessed 19 March 2023.
Cynthia Cox, Jennifer Kates, Juliette Cubanski, and Jennifer Tolbert. Kaiser Family Foundation. The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access. 3 February 2023.
Hannah Recht. PBS News Hour. COVID-19 treatment Paxlovid has been free so far. Next year, sticker shock awaits. 18 December 2022.
Jennifer Tolbert and Meghana Ammula. Kaiser Family Foundation. 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision. 22 February 2023.
Juliette Cubanski, Jennifer Kates, Jennifer Tolbert, Madeline Guth, Karen Pollitz, and Meredith Freed. Kaiser Family Foundation. What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access. 31 January 2023.
Rebecca Corey. Yahoo News. The COVID public health emergency is ending — but what does that mean, and who will be impacted? 27 February 2023.
Sharon LaFraniere and Noah Weiland. The New York Times. U.S. Plans to End Public Health Emergency for Covid in May. 3 February 2023.
U.S. Department of Health and Human Services. Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap. 9 February 2023.
