Key takeaways:
The COVID-19 public health emergency (PHE) ends on May 11, 2023. After that, you could face changes to your out-of-pocket costs for vaccines, tests, and treatments.
Automatic renewals for Medicaid and Children’s Medicaid (CHIP) will stop on March 31, 2023. This is part of the PHE unwinding process, which is already in progress.
After the PHE ends, you may have access to fewer healthcare providers because of changes to telehealth coverage and out-of-state provider licensure rules.
COVID-19 infections, illnesses, hospitalizations, and deaths aren’t over. But the pandemic’s emergency status has an end date in the U.S. After more than 3 years, the public health emergency declared for COVID in January 2020 will conclude on May 11, 2023.
The end of the emergency will affect everything from telehealth access to Medicaid renewal. Here’s a rundown of what to expect and how you can prepare for any changes you might encounter.
What is a public health emergency?
A public health emergency (PHE) can be prompted by infectious diseases, natural disasters, or other urgent situations in a state, region, or nationwide.
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Based on COVID-19 confirmed cases, the U.S. Department of Health and Human Services (HHS) secretary determined that SARS-CoV-2, the virus responsible for the outbreak, warranted a PHE. HHS declared the emergency in January 2020. The declaration was renewed a dozen times through February 2023.
When does the COVID-19 PHE end?
The COVID-19 PHE is set to end on May 11, 2023. This process is called the unwinding and has already started. According to HHS, the virus that causes COVID-19 remains a public health priority but is no longer an emergency.
How does the end of the COVID-19 PHE affect healthcare access?
The end of the PHE means changes for some aspects of healthcare. Here’s what will remain the same and what will change.
COVID-19 vaccinations
Access will generally not be affected and most people will continue to pay nothing out of pocket for the COVID vaccines.
Vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) are preventive health services and fully covered by most private health insurance plans with no copay. All four COVID vaccines in use in the U.S. are ACIP recommended (Moderna, Pfizer, Johnson & Johnson, and Novavax).
Vaccines will continue to be covered by Medicare Part B without cost-sharing.
Medicaid will continue covering ACIP-recommended vaccines without copays or cost-sharing through September 30, 2024. Coverage will continue for most Medicaid enrollees thereafter.
COVID-19 testing
Medicare Part B enrollees will no longer have access to free over-the-counter COVID tests. They will, however, continue to be covered for laboratory COVID-19 tests without cost-sharing if a provider orders the tests.
Private insurance will no longer be required to cover over-the-counter and lab COVID-19 tests without cost-sharing. But plans may choose to continue coverage without out-of-pocket costs.
Medicaid must cover COVID-19 tests without cost-sharing through September 30, 2024. After that date, coverage will vary by state.
COVID-19 treatments
Access to Paxlovid and Lagevrio pills will generally not be affected. But out-of-pocket expenses may change depending on your health insurance coverage.
Medicaid will continue to cover treatments without cost-sharing through September 30, 2024. But coverage and cost-sharing may change after that date depending on your state.
Medicaid renewals
During the PHE, yearly Medicaid renewals were replaced with continuous coverage.
Automatic Medicaid and Children’s Medicaid (CHIP) renewals will end on March 31, 2023. Enrollees could lose coverage as early as April 1, 2023 in some states.
Medicare telehealth
Medicare enrollees, particularly those in rural areas, have had greater access to care via telehealth during the PHE.
Expanded telehealth access through Medicare will remain in place through December 31, 2024.
Medicaid telehealth
Medicaid provided and paid for telehealth services before the PHE, particularly for enrollees in rural areas and those with limited mobility.
Those services will continue to be offered after the PHE ends but will vary by state.
Opioid treatments
Early in the pandemic, providers gained the flexibility to allow people to start taking buprenorphine in opioid treatment programs (OTPs) via telehealth without an in-person physical exam. Access to buprenorphine for opioid use disorder in OTPs will not be affected.
Early in the pandemic, providers were able to increase the number of methadone take-home doses for people in OTPs. Access to expanded methadone take-home doses for opioid treatment disorder will not be affected through at least May 11, 2024.
Healthcare providers
Hospitals, nursing homes, and other facilities have had the flexibility to meet pandemic demand and expand capacity by hiring physicians, nurse practitioners, and other providers who were licensed in other states.
These waivers will end when the PHE is over.
During the pandemic, some states have been able to increase the number of people served through Medicaid and expand the support offered. Some Medicaid flexibilities will end, but others will continue after the PHE ends, such as those concerning home and community-based services.
COVID-19 data reporting
After the PHE ends, HHS will no longer have authority to require lab test reporting for COVID-19.
FDA emergency use authorization
An emergency use authorization (EUA) allows an unapproved test, vaccine, or treatment to be used during a PHE.
Existing EUAs for COVID-19 products will remain in effect after the PHE ends, and the FDA may issue new ones when criteria are met.
What does the end of the COVID-19 PHE mean for me?
The end of the PHE means states will resume normal Medicaid operations and stop additional emergency allotments for the Supplemental Nutrition Assistance Program known as SNAP or food stamps. Millions of people saw their SNAP benefits reduced in March 2023 because of the unwinding.
One of the most profound effects of the PHE ending is the potential number of people who will lose Medicaid coverage (5 million to 14 million according to some researchers and nearly 18 million according to the highest estimates).
That may apply to you. Make sure your state Medicaid agency has your correct contact information so that you can be reached when it’s you and your family’s turn to be considered for coverage renewal.
If you lose Medicaid coverage, you and your family may qualify for a plan on the Affordable Care Act (ACA) marketplace that costs $10 or less per month with financial help. Depending on your age and conditions, you may be eligible for Medicare.
You may also be responsible for paying more for COVID-19 tests, vaccines, and pills if you have insurance. If you are uninsured, tests, shots, and treatments like Paxlovid may no longer be free.
What should I do if I have issues with healthcare when the COVID-19 PHE ends?
The end of the PHE may mean you lose access to your provider, telehealth options, or free medications. Public health officials are strongly advising people who are uninsured or those who lose Medicaid coverage to see if they qualify for an ACA plan or Medicare. You should also reapply if you are not renewed by Medicaid and believe you qualify.
You can also consider options in the GoodRx Health guide for free and low-cost healthcare and save money on your prescriptions by using GoodRx.
The bottom line
The COVID-19 public health emergency (PHE) ends on May 11, 2023, and this may change what you pay for vaccines, tests, and treatments. This process is called the unwinding.
Automatic Medicaid renewals, which have been happening for 3 years, will end on March 31, 2023. When the PHE is no longer in force, you may also have access to fewer healthcare providers via telehealth due to the end of relaxed out-of-state provider licensure rules.
If you lose Medicaid coverage or don’t have insurance, see if you qualify for Medicare or an ACA marketplace plan. You can also reapply for Medicaid if you lose coverage in your first eligibility review.
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References
Centers for Medicare & Medicaid Services. (2023). Coronavirus waivers & flexibilities.
Erzouki, F. (2023). States must act to preserve Medicaid coverage as end of continuous coverage requirement nears. Center on Budget and Policy Priorities.
HealthCare.gov. (n.d.). Health benefits & coverage.
Health Resources & Services Administration. (2023). Telehealth policy changes after the COVID-19 public health emergency.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Recht, H. (2022). Paxlovid has been free so far. Next year, sticker shock awaits. Kaiser Family Foundation.
Rosenblum, H. (2022). Interim recommendations from the Advisory Committee on Immunization Practices for the use of bivalent booster doses of COVID-19 vaccines — United States, October 2022. Morbidity and Mortality Weekly Report.
Sullivan, B. (2023). What SNAP recipients can expect as benefits shrink in March. NPR.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Department of Health & Human Services. (2023). Fact sheet: COVID-19 public health emergency transition roadmap.
U.S. Department of Health & Human Services, Administration for Strategic Preparedness and Response (ASPR). (2020). COVID-19 (January 31, 2020).
U.S. Department of Health & Human Services, Administration for Strategic Preparedness and Response (ASPR). (2023). COVID-19 (February 9, 2023).
U.S. Food and Drug Administration. (2023). FAQs: What happens to EUAs when a public health emergency ends?
Weiland, N., et al. (2022). For the uninsured, Covid care has entered a new stage of crisis. The New York Times.
