The COVID-19 public health emergency is over. What does that mean for Floridians? (2023)

On Jan. 31, 2020, as a new coronavirus swept across the world and began affecting people in the United States, President Donald Trump declared a public health emergency.

This allowed the federal government to move quickly to address what became a pandemic that, over three years of social upheaval and personal tragedy, led to over a million deaths in the U.S. with over 100 million people infected. Florida alone has seen 7 1/2 million cases of COVID-19 and over 88,000 deaths, and those numbers are still rising every week.

During that time, because of the speed of the government and the massive funding provided, Americans received free COVID-19 tests, vaccines and boosters regardless of insurance, But now the end of the public health emergency means significant changes to COVID testing and treatment, vaccines, data reporting, health coverage, and telemedicine. Here's what that means for you.

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Why is the COVID public emergency ending?

There were two declarations, a COVID-19 national emergency, set to expire March 1, and a public health emergency, set to expire April 11. GOP members of the House have been pushing for an end to them as being unnecessary, but the Biden Administration extended them both to end on May 11 so the change would not be as abrupt and avoid "wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans."

COVID-19 is no longer the danger it once was, although it is definitely still a concern. The World Health Organization said thatCOVID-19 no longer qualifies as a global emergency. The CDC reported 1,109new weekly COVID-19 deathsas of May 3, down from more than 23,600 the week of Jan. 13, 2021. More than 77,000 cases were reported for the week, down from a peak of 5.5 million in January 2022. Hospital admission trends are also falling, with theseven-day averagedown from its peak of 21,525 in January 2022 to 1,349 as of Monday.

However, David Weber,associate chief medical officer and medical director of infection prevention at the University of North Carolina Medical Center and vice president of theSociety for Healthcare Epidemiology of America. notes COVID-19 is “still a major issue” with more than 100 people in the U.S. on average dying from the virus daily. He expects the virus will continue to be amongthe top five causes of deathin the United States this year.

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When does the COVID public emergency end?

At the end of the day on Thursday, May 11, 2023.

What did the COVID public emergency do?

The emergency declarations gave the federal government the flexibility to make sweeping changes, freed up disaster money to fightthe spread of the virus andreduced health regulations that could slow action. For example, hospitals were allowed to screen patients for COVID-19 off campus.

The funding allowed the government to buy and distribute masks and other personal safety gear to hospitals and healthcare facilities, provide cash for states to help with their efforts, and pay for vaccines, boosters and tests for millions of Americans.

Will COVID vaccines and boosters still be free? Will I have to start paying for them?

The federal government will no longer be buying vaccines to provide for free, and pharmaceutical companies are expected to bring the prices up.

Manufacturers Pfizer-BioNTech and Moderna sold their vaccines to the government for about $20 a dose, saidDr. Bruce Y. Lee, professor of health policy management at City University of New YorkGraduate School of Public Health and Health Policy. But now, both companies said they're considering price hikes between$110 and $130,Lee said.

But most Americans will probably still be able to get COVID vaccines for free. According to the U.S. Department of Health and Human Services, Americans will still be able to get COVID-19 vaccines at no cost for as long as the stockpiles last. When they're gone, COVID-19 vaccines and treatments will become like any other medical treatment, handled by the healthcare system, just as shots for the flu are now.

  • Private insurance: Under the Affordable Care Act, private health plans must cover routine preventative services such as vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) and should be fully covered without a co-pay when using an in-network provider, although the requirement to cover out-of-network vaccines will stop.
  • Medicaid: COVID vaccinations will be covered without a co-pay or cost sharing through September 30, 2024, and Medicaid will "generally cover" ACIP-recommended vaccines after that, the U.S. Department of Health and Human Services said. But if you enrolled in Medicaid during the pandemic, you may be losing it now that the emergency declaration is over (see below).
  • Medicare: COVID vaccinations will be covered under Medicare Part B and Medicare Advantage without cost sharing.
  • No insurance? See below.

Out-of-pocket expenses for some treatments, such as Paxlovid and Lagrevio, may change, depending on your coverage.

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What if I don't have insurance? Will I be able to get COVID vaccines and boosters?

In April, the CDC announced the HHS Bridge Access Program for COVID-19 Vaccines and Treatments Program to provide COVID-19 care through 2024 for uninsured people at local pharmacies, through existing public health infrastructure, and at local health centers.

It has not been announced if this is an opt-in program and whether it will be made available in Florida.

Will I be able to get free COVID tests after the public health emergency ends?

You will be able to order free at-home COVID-19 tests through through at least the end of May, but they may not last much longer now that the Biden administration is no longer buying them.

  • Private insurance: Insurance providers will no longer have to waive costs or provide free tests, butthe Department of Health and Human Services saysit is encouraging private insurers to continue covering tests. Check with your own insurance to see what it will offer moving forward.
  • Medicaid: Anyone with coverage through Medicaid or the Children's Health Insurance Program can continue to get rapid tests through Sept. 30, 2024. State Medicaid programs will decide what to cover after that.
  • Medicare: Enrollees will no longer receive free at-home tests but lab tests are covered.
  • No insurance? Some communities may still receive stockpiled tests and the Centers for Disease Control and Prevention (CDC) has aNo Cost COVID-19 Testing Locator that can help you find free or reduced tests in your area.

Polymerase chain reaction tests — knownas the PCR tests — are considered "the gold standard"for detecting the COVID-19 virus, health experts say, but they can cost up to $100 if not covered.

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Will the CDC still track COVID cases and deaths after the public health emergency ends?

Not the same way. As of May 12, the CDC will no longer have authorization to collect some of the data it has been getting and labs will no longer be required to report test results. That means no more weekly updates, no more reports of virus transmission levels, no more state- or county-specific data on variants.

Instead, the CDC will use information from hospitals, the National Vital Statistics System, wastewater testing and whatever data on cases, deaths and vaccine counts that labs, agencies or jurisdictions continue to share.

The agency says it will still be able to track outbreaks and movement.

"Simply put, while what we have going forward will be different," the CDC said on its website, "it will still allow CDC, local public health officials, and the members of the public to understand COVID-19 dynamics at the community level."

The Florida Department of Health has not said if it will continue issuing its biweekly COVID reports. The FDOH has not issued an announcement regarding COVID-19 since October, 2022, when it warned that men younger than 40 faced higher risks ofdying from heart problems after receiving Pfizer and Moderna vaccines and boosters. Florida Surgeon GeneralJoseph Ladapo was rebuked by doctors, scientists and the federal government for the report, which a University of Florida task force found to be cherry-picked and "highly questionable."

Can I still get telehealth appointments?

One of the most useful changes that came about due to the pandemic was the massive expansion of telehealth services. Will that change?

We'll have to wait and see. Telehealth access under Medicare has been extended through 2024 but each state can make its own decisions about telehealth through Medicaid and every private insurer can set its own policies.

Meanwhile on Tuesday, the Drug Enforcement Administrationextended a pandemic-era policyuntil Nov. 11 that allows telemedicine doctors to prescribe controlled substances such as buprenorphine and Adderall without an in-person medical appointment. Under the temporary rule, patients and prescribers with a relationship as of Nov. 11 will be able to get remote prescriptions through Nov. 11, 2024.

What happens to Medicaid?

Medicaid is jointly funded by state and federal governments.During the public health emergency, the federal government provided billions in federal aid to stateson the condition that theywould not remove people from Medicaid until theemergency ended. Eligibility requirements also were waived for the duration.

This caused a massive swell in the number of Floridians on Medicaid, which serves low-income people, seniors and people with disabilities. In March 2020, Florida had about 3.76 million people enrolled in Medicaid. By November last year, that number had risen to nearly 5.58 million people enrolled, according to the state Agency for Health Care Administration. In December, Gov. Ron DeSantis joined 24 Republican governors in a letter to President Joe Biden asking to end the emergency declaration because of the increased cost.

Now that the emergency declaration is ended, nearly 1 millionFloridians are at risk of losing their healthcare coveragethrough Medicaid. Some could be dropped because they are no longer eligible, while others could lose their coverage because they didn't complete the renewal process by the end of April or because they moved.

Also, Medicaid recipients will have to resume annual eligibility checks in place pre-pandemic, and potentially more frequently if they use certain benefits such as the federal Supplemental Nutrition Assistance Program (SNAP).

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What will happen to food and benefit programs?

Some of the rules relaxed during the emergency declaration that allowed boosts in SNAP benefits will be back in force, according to the USDA Food and Nutrition Service.

  • Student exemptions: As of June 10, exemptions for students to receive SNAP benefits will be phased out.
  • Relaxed work requirements: Beginning July 1, 2023, able-bodied adults without dependents ages 18-49, also known as ABAWDs, will once again be required to meet the ABAWDwork requirements, or they could risk losing SNAP benefits as soon as October 2023.
  • Homeless aid: Beginning May 11, 2023, program operators in the Child and Adult Care Food Program (CACFP) will no longer be able to provide for homeless young adults ages 19-24 at emergency shelters.
  • Pandemic EBT: P-EBT for children in childcare will end May 11 but will continue for school children through the end of summer 2023.
  • WIC: Most of the flexibilities FNS provided to WIC participants during the pandemic will continue to be available under a separate authority Congress provided FNS in theAmerican Rescue Plan Act.

Contact your local program office for details on how these changes may affect you and your family.

What else is changing in Florida?

Florida has already been drawing down on COVID changes. While some states still have some sort of COVID emergency declaration in place, DeSantis suspended local emergency orders and blocked mask and vaccine mandates in May 2021, and declined to continue Florida's COVID emergency order two months later.

Hospitals will no longer get an extra 20% for treating Medicare patients diagnosed with COVID-19 and some relaxed training and hiring policies will change back.

Contributors: Adrianna Rodriquez, Maureen Groppe, Ken Alltucker, USA TODAY; Hannah Morse, Palm Beach Post


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