February 3, 2023
On Monday, President Biden caught up with the vast majority of Americans with the announcement that his administration will end the COVID-19 national emergency as well as the related public health emergency (PHE) on May 11, 2023. The pandemic era was many things – deadly, painful, divisive, expensive – and while the country has mostly gone back to “normal,” it’s worth taking stock of both the many policy and personal implications of those years, as well as how much will change after the emergencies officially end.
First, since the Centers for Disease Control and Prevention (CDC) began recording deaths on March 4, 2020, over 1.1 million Americans have died from COVID-19. That number is possibly an undercount, and we may never know the true toll of the disease. Additionally, we cannot forget the deaths of despair that increased dramatically during the pandemic. Meanwhile, COVID-19 is still very much around. On the week of January 25, 2023, an estimated 3,756 Americans died from the virus. While the PHE is ending, COVID-19 has not.
On the health policy front, one can expect several changes once the PHE ends. To start, vaccines, tests, and treatments will no longer be guaranteed free of cost-sharing. Those with private insurance may face coinsurance costs for drugs, and those without any insurance will have to pay out of pocket for everything. Vaccines will remain free for those on Medicare, Medicaid, or the Children’s Health Insurance Program, but those individuals may face cost-sharing for tests and antivirals. Telehealth flexibilities in Medicare will remain through 2024, but employers can no longer offer the service as a separate, tax-free benefit. Loosened prescribing rules for controlled substances are expected to tighten back up. Certain Medicare coverage requirements waived during the pandemic will be reinstated, and Medicare Part D will no longer allow patients extended supplies of many drugs. Hospitals will lose the 20 percent increase in Medicare payments for treating COVID-19 patients. Additionally, states that have work requirements for those on federal food programs will reinstate them.
Notably, the CDC has taken a long, hard look at its own pandemic-era decisions. To its credit, the agency has recognized its often confusing messaging and lackluster handling of public education and has committed to work on restoring public trust. Last week, the CDC announced an update to its organization chart that hopefully, among other things, will strengthen its outreach and communications to ensure its reasoning is transparent and messaging is clear. This is part of a broader CDC revamp begun in August 2022 by Director Rochelle Walensky, and the agency’s follow-through is encouraging.
Whatever the public health metrics say about COVID-19’s continued prevalence, a Morning Consult poll shows that only about a quarter of adults remain “very concerned” about a future COVID-19 outbreak, and only 12 percent say that the virus presents a severe health risk to their community. Bars and restaurants are packed again, public transit is once more uncomfortably crowded, and you can actually distinguish faces again in public without all the masks. The Biden Administration finally acknowledged what the rest of us already knew. Better late than never.