On Thursday, the U.S. Department of Health and Human Services (HHS) is set to let the federal public health emergency over the COVID-19 pandemic expire, but not everyone sees it as a reason to celebrate. HHS Secretary Xavier Becerra extended the emergency for 90 days in February, signaling at the time that it would be the final extension.
One month after President Biden signed a Republican-backed bill repealing a separate national COVID emergency that President Trump declared in March 2020, and six days after the World Health Organization declared an end to the global COVID emergency, the latest news appears to be the culmination of a growing consensus that COVID-19 is no longer a crisis.
But more than 1,000 Americans are still dying each week from COVID-19, and countless others are dealing with debilitating, long-term COVID-19. That’s why disability protection advocates say it’s dangerous and irresponsible to let the protections that come with the public health emergency lapse.
“We called the fire department while the house was still burning because the neighbors want it to be over,” Laurie Jones, executive director of #MEAction, an organization that advocates for people with myalgic encephalomyelitis, a chronic fatigue disorder that a large proportion of long-term COVID patients develop, said at a press conference on Wednesday.
Below is a guide to what the expiration date means and what some people say you shouldn’t forget.
What had already changed?
The national emergency that ended last month gave the federal government a broad range of powers over the economy. For example, it gave the Department of Housing and Urban Development (HUD) the ability to set up the COVID-19 mortgage forbearance program. That program expires at the end of May, and the Department of Veterans Affairs has begun requiring home visits again to determine eligibility for a program that pays for home caregivers.
What will change now
The public health emergency that ended May 11 allowed the federal government to provide COVID-19 testing, treatments like Paxlovid, and vaccines for free. Americans with Medicare or private insurance plans could get up to eight COVID tests a month at pharmacies with no copay. (Medicaid eligibility varied by state.) Therapeutic treatments like monoclonal antibodies were fully covered by Medicare and Medicaid.
That’s all changing. Medicare beneficiaries will now have to pay a portion of the cost of at-home COVID testing and COVID treatments. In principle, COVID is covered the same as other conditions. People with Medicaid coverage will get free vaccines and COVID testing if prescribed by a doctor, but they will have to pay out of pocket for at-home testing. People with private insurance may have to pay for tests, even if prescribed by a doctor, and for COVID treatments.
“People are going to have to pay some money for things that they didn’t have to pay for during the emergency,” Jen Kates, a senior vice president at the Kaiser Family Foundation, told CNN when the May 11 deadline was first announced. “That’s the biggest thing that people are going to notice.”
Tests will remain free until the government-purchased supply runs out.
There will also be less comprehensive tracking of the spread of COVID-19. Infections will no longer be tracked, only hospitalizations, and the Centers for Disease Control and Prevention (CDC) will no longer offer a color-coded assessment of the severity of COVID-19 in each county.
Perhaps most controversially, Title 42, a part of the Trump-era public health emergency that allowed the U.S. to quickly remove migrants, is set to expire. Officials expect a subsequent surge of migrants at the southern border. In response, Republicans in Congress are pushing a bill to roll back some of Trump’s immigration policies, including construction of a border wall.
What will not change
Vaccinations remain free for everyone with health insurance, thanks to federal laws including the Affordable Care Act and pandemic relief bills.
For people without insurance, all of these benefits have already become expensive, as federal funds for free COVID-related health care for the uninsured ran out late last year.
What is there apart from the emergency?
A March 2020 COVID relief law prohibited states from removing anyone from Medicaid during the public health emergency, but Congress rolled that back last year, allowing states to revoke Medicaid coverage starting April 1 of this year. Millions of people, including an estimated 6.7 million children, could lose coverage as a result.
Food stamps were also increased as part of a 2020 emergency measure, but it expired in March.
The expanded access to telehealth established during the public health emergency will continue to be maintained separately until the end of 2024.
Which risk groups may need more?
Many people with disabilities are at greater risk of contracting COVID-19 or developing severe symptoms due to prior conditions such as a weakened immune system. Disability advocates worry that some people will not be able to protect themselves without free access to testing and treatment. They note that free access could be extended through separate legislation rather than an extension of the state of emergency.
To protect those most vulnerable to infection, disability rights activists argue that mask mandates should still be in place in healthcare settings — though that’s managed at the state level — and that the CDC should still track COVID numbers so people can make informed decisions about how much they want to be in public.
“The pressure to end public health [emergency] “It was huge, but it didn’t have to be an either-or situation,” Jones said Wednesday. “It could have been both-and. We could have helped people come back into the world while they were still wearing masks in the hospital, tracked COVID numbers, warned people about spikes in their area. We could have still offered free testing and free treatment.”
Some public health experts agree, warning that new variants of the coronavirus could prove more contagious or deadly. “The need for active management of the virus remains. Many thought the pandemic was over in the spring of 2021,” Julia Raifman, a professor of public health at Boston University, told Yahoo News in April. “Unfortunately, we were unprepared for new variants, and we lost hundreds of thousands of lives in the months that followed. By actively monitoring COVID, continuing the work to help people get vaccinated and incentivized, and having policies and supplies in place to address new variants, we can help ensure we don’t see such a high, preventable toll again.”
