The federal government declared a Public Health Emergency (PHE) at the start of the pandemic. That declaration cleared the way for flexibility in funding and operating health and social service programs. COVID-19 remains a serious illness, but the “Public Health Emergency” label will expire May 11, 2023. Several programs connected to the PHE will change or end that day or in the months to follow.
More information regarding who will be affected, how states and communities are responding, and what people should do to adapt to the change will be forthcoming. For now, it’s important for outreach organizations to know about this upcoming federal action and take note of how it may affect the communities they serve.
Here’s what we know so far:
Medicaid eligibility
During the PHE, people with Medicaid coverage, called Apple Health in Washington, could keep the coverage even when their incomes rose or they experienced another change that would normally make them ineligible for Medicaid.
With the PHE ending, and due to federal legislation that ended this “continuous coverage” feature, states will resume regular checks to confirm or deny eligibility for Medicaid. It will be important for people with Medicaid to keep their contact information updated and reply promptly if Apple Health contacts them to renew their coverage.
COVID-19 testing
Medicare and private insurance plans have been required to fully cover COVID-19 home tests for their customers, charging no out-of-pocket cost for up to eight tests per enrolled person enrolled per month. That requirement ends May 11, 2023.
Medicaid has also been required to fully cover COVID-19 tests. That requirement will end September 30, 2024.
The federal program that mailed free tests through the postal service to anyone who ordered them—insured or not—will end May 11.
COVID-19 vaccines
Medicare will continue to fully cover COVID-19 vaccines, and Medicaid programs must fully cover them through September 30, 2024. Most private insurance plans must also fully cover COVID-19 vaccines when patients get the vaccine from an in-network provider. People without insurance or with health plans not subject to the coverage requirement may have to pay for vaccination.
COVID-19 treatments
The costs of COVID-19 treatment drugs have been covered by the federal government. That will end May 11, 2023, and treatments will be covered according to the regular terms of a person’s health plan, if they have coverage. Medicaid programs will continue to fully cover COVID-19 treatments through September 30, 2024.