For the past three years, most Americans have benefited from access to free COVID-19 tests, treatments and vaccines–regardless of insurance status, thanks to funding from the federal government.
But it seems that this is about to change as the Biden administration plans to end both the national emergency and the public health emergency on May 11. Access to COVID-19 services will now depend on your insurance coverage through Medicaid, Medicare or private companies.
The end of the public health emergency may also jeopardize coverage for millions of Americans. Those who are uninsured, which is approximately 8.5% of the US population, have few options for COVID-19 care, according to public health officials.
The Biden administration will be shifting health care costs associated with COVID-19 from the government back to individual Americans. Based on your insurance coverage, here’s how the end of public health emergency services may affect you.
COVID-19 tests
Ordering free at-home tests through government funded sites like COVIDtests.gov is likely to go away with the end of the public health emergency. Here are some others to consider:
- Medicaid: Free tests until 2024.
- Medicare: No longer will receive at-home tests for free.
- Private insurers: Varies by state and insurance company.
Polymerase chain reaction tests – known as the PCR tests – are considered “the gold standard” for detecting the COVID-19 virus, but they may cost $100 or more, if you’re not covered.
COVID-19 vaccines
With the emergency declaration ending, there may be new economic barriers to getting vaccinated. Manufacturers Pfizer-BioNTech and Moderna sold their vaccines to the government for about $20 a dose. But now, both companies said they’re considering price hikes between $110 and $130, between the two. Here’s how the vaccines are also being affected:
- Medicaid: Free vaccines, no end date determined.
- Medicare: Undetermined.
- Private Insurers: Varies by state and insurance company.
While private insurance companies may be inclined to cover vaccines similar to annual influenza shots, nothing is guaranteed. Those without insurance coverage may have to pay the entire cost out of pocket.
COVID-19 treatment
There aren’t very many treatment options for COVID-19, especially after the FDA announced that monoclonal antibody Evusheld is no longer authorized to prevent SARS-CoV-2 infection in the US. Ending the public health emergency may limit access to the few drugs that are currently available, including antiviral Paxlovid from Pfizer. How does COVID-19 treatment get affected:
- Medicaid: Covered until 2024.
- Medicare: Covered through 2024.
- Private Insurers: Varies by state and insurance company.
This also affects the future of Covid booster shots. The lack of emergency funding and a return to the slow approval process may demotivate companies from funding research into more COVID-19 treatments and better vaccines.
Telehealth
Before 2020, most states had rules that limited access to telehealth services depending on where someone lived. But COVID-19 and the public health emergency blew that door wide open.
The availability of telehealth was no longer geographically restricted. There was an expansion of access, particularly through Medicare and Medicaid. There’s some concern that a lot of people will lose access to telehealth now that the declaration is ending. Health experts worry this may disproportionately affect Americans living in rural areas and those with limited access to general health care services. How will this affect you:
- Medicaid: States to decide.
- Medicare: Covered through 2024.
- Private Insurers: Varies by state and insurance company.
Medicaid coverage
Before the pandemic, Medicaid recipients underwent a yearly review to make sure they were still qualified for benefits. Now, with the public health emergency, that paused the yearly review (which had prevented states from taking people off of Medicaid.)
With the review process resuming, millions of Americans are at risk for not qualifying and losing their Medicaid coverage.
Hospital funding
When the emergency declaration ends, it may mean hospitals won’t get extra funding. During this public health emergency, hospitals received an approximate 20% increase in funds, if they discharged a Covid patient alive and this will also be ending. Health experts fear the lack of funding will lead to more hospital closures, particularly in rural areas, and will leave health care providers unprepared for future coronavirus waves.
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