On May 11, the Biden administration plans to end the pandemic’s classification as a public health emergency. This will usher in a complex wave of policy changes that may make testing and treatment more difficult for Americans.
Dr. Peter Chin-Hong, an infectious disease expert at UCSF, said, “The one word I have to describe this all is ‘confusion.'” Finding out where to go, who will pay for what, and how much your share will be can be difficult. It’s going to be a very difficult equation now.
Experts in health policy have made some predictions about how the end of the public health emergency might affect you, but the details are still sketchy.
Private insurance, if you have it
According to Jennifer Kates, senior vice president at the Kaiser Family Foundation, the biggest change most people will notice is that their insurance probably won’t cover eight free at-home Covid tests per month.
Dr. Kates has advised that people take advantage of free tests at their local library or a Covid testing centre before the emergency declaration ends; they should, however, make note of the expiration date. After that date, those covered by private insurance will likely be required to pay full price at pharmacies for Covid tests that can be performed at home.
Paxlovid and P.C.R. tests, even if prescribed by a doctor, may now incur additional costs for patients, according to Dr. Kates. The exact cost of these co-pays is still unknown, but she speculated that they would be on par with the price of any doctor-recommended medications or diagnostic procedures. According to Jose Francisco Figueroa, assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health, costs may differ depending on the specifics of each plan.
Dr. Kates has stated that patients with private insurance who visit an in-network provider for their Covid vaccinations will not incur any costs. She attributed this to the fact that the ACA’s policy changes were implemented before the pandemic hit.
Individuals enrolled in Medicare
According to Natalie Davis, founder and chief executive officer of United States of Care, a nonprofit that advocates for greater access to health care, Medicare recipients may be required to pay co-pays for therapies such as antivirals and doctor-ordered tests. Dr. Kates assured them that, thanks to the CARES Act and regulations implemented by the Centers for Medicare & Medicaid Services during the pandemic, they will continue to have access to free Covid vaccines.
She also noted that Medicare recipients, who had previously been eligible for eight free at-home Covid tests per month, would now likely be required to pay the full price for such tests.
To those who qualify for Medicaid
Because of a provision in the American Rescue Plan, Dr. Kates said, Medicaid patients have access to Covid tests and treatments at no cost until 2024. A provision in the Inflation Reduction Act will make vaccines available to them at no cost, she added.
If you don’t have insurance
Dr. Kates warned that when the public health emergency ends, so may the temporary Medicaid coverage for tests, treatments, and vaccines that some states have provided to the uninsured.
Those without health insurance face significant barriers when attempting to receive care at a Covid clinic. Ms. Davis remarked, “This is the population that slips through all the cracks in our system.” Public health services, which may or may not be available to them depending on where they live, will likely be their only option. Dr. Chin-Hong predicted that “different states will have different safety nets.” “It will ultimately be a regional issue.”
Ultimately, the wording may reinforce the mindset many people have embraced for months, if not years, said Dr. Paul Offit, a vaccine expert at the Children’s Hospital of Philadelphia. This is despite concerns raised by health policy experts about the implications of the pandemic moving out of official “emergency” status.
It’s over, he said, and the American public has accepted that idea.