WASHINGTON — The Biden administration’s plan to unwind the public health emergency tied to the COVID-19 pandemic will spur a whirlwind of changes related to telehealth, Medicaid, pharmaceuticals and other priorities.
Many Republicans have said the May 11 end date announced Monday is not soon enough, with the House voting this week on a bill to roll back that and three other pandemic policies immediately. Democrats have said the time is needed to weigh which flexibilities and funding may need to continue.
Still, U.S. plans to end the emergencies stand in contrast to the opinions of other global health leaders, with World Health Organization Director-General Tedros Adhanom Ghebreyesus on Monday saying the pandemic is nearing a “transition point.” He aligned himself with a WHO committee that said it “requires a focused commitment of WHO, its Member States and international organizations” and that “long-term public health action is critically needed.”
Sen. Bernie Sanders, the incoming chairman of the Health, Education, Labor and Pensions Committee, also seemed wary.
“We are seeing a massive amount of sickness right now. And there’s no reason to believe — and I hope that it’s otherwise — that that’s going to change in the immediate future,” said Sanders, I-Vt.
But many argue that there is no longer a justification for the public health emergency, even though unwinding the flexibilities associated with that will take time.
“You can even argue that there’s more tools to deal with COVID-19 than there are to deal with any other respiratory virus,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
Cost sharing, payment changes
Ending the public health emergency means people will likely have to pay more out of pocket for COVID-19 testing and treatment, and planned price increases among COVID-19 vaccines and treatments have drawn congressional scrutiny.
Both Moderna and Pfizer plan to increase prices from the government rate of around $25 to $30 per dose to as much as $130.
Sens. Elizabeth Warren of Massachusetts and Peter Welch of Vermont accused Pfizer of “pure and deadly greed” over the news in December. Sanders labeled Moderna’s expected increase “unconscionable” last month.
For the millions of people enrolled in Medicare, meanwhile, cost-sharing requirements for COVID-19 treatments will resume when the public health emergency ends. Enrollees will also likely have to pay full cost for at-home tests. The same goes for Medicaid beneficiaries, although cost sharing for testing and treatments will resume in 2024 under a provision in a COVID-19 relief law.
And while private insurers were required to provide or pay for eight free COVID-19 tests per month during the public health emergency, that provision will expire when the PHE does. Insured individuals will still have access to COVID-19 vaccines after the end of the emergency, but uninsured people will no longer be eligible for free COVID-19 testing, vaccines or treatment through Medicaid.
“Throughout the pandemic, people have been able to get what they need, regardless of their ability to pay. And we’ll be moving into a phase where that will be different,” said Natalie Davis, CEO of health advocacy group United States of Care.
But commercializing the products will have its upside, Adalja said, including the ability to freely market products that federal officials and many experts believe are underutilized, like Paxlovid.
