Ending COVID-19 Emergency Declarations Will Bring an End to Flexibilities that Aided Patients, Providers, Insurers, and Public Programs in Responding to the Pandemic

When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several changes that were enacted temporarily to enable the U.S. health care system to better deal with the crisis.

A new KFF resource details a number of those flexibilities and lays out what it will mean for people, providers and federal health programs when they go away. One of the key declarations, the COVID-19 Public Health Emergency, is slated to expire on April 16, though it is expected to be renewed by the Biden administration. The end of the emergency declarations also will bring about a ramping down of heightened federal spending related to the pandemic, which was always intended to be temporary.

The changes will eliminate a pathway through Medicaid to free COVID-19 testing, treatment and vaccines for people without health insurance and could trigger higher out-of-pocket costs for tests for people with private insurance. Millions of people could lose Medicaid coverage when the continuous enrollment requirement ends and the federal government shuts off pandemic-related enhanced federal Medicaid funding.

Most Medicare beneficiaries would lose access to coverage of nearly all telehealth services within a few months, with some exceptions, and hospitals would no longer receive a special pandemic-related 20 percent increase in Medicare payments for treatment of patients diagnosed with COVID-19. In addition, any COVID tests, vaccines, or therapeutics that were granted emergency authorization for use but have not been approved by the FDA could no longer be used.
The new KFF resource addresses flexibilities adopted during the COVID-19 pandemic and implications of their drawing to a close in the following areas:

• Coverage, costs, and payment for COVID-19 testing, treatments, and vaccines
• Medicaid coverage and federal match rates
• Telehealth
• Other Medicaid and CHIP flexibilities
• Other Medicare payment and coverage flexibilities
• Other private insurance coverage flexibilities
• Access to medical countermeasures (vaccines, tests, and treatments) through FDA emergency use authorization (EUA)
• Liability immunity to administer medical countermeasures

For more COVID-19-related analyses and data, visit kff.org.