COVID-19 public health emergency extended once again

Three years after COVID-19 was declared a public health emergency, the U.S. Department of Health and Human Services extended that emergency for another 90 days.

HHS Secretary Xavier Becerra made the announcement amid concerns over a more transmissible viral mutation and broad pandemic fatigue.

Wednesday’s announcement marks the 12^th time the public health emergency has been renewed. Each renewal is good for 90 days before expiring or being extended.

The public health emergency extension also ensures that policies such as telehealth coverage, and extra payments to hospitals and doctors will continue.

Millions on brink of losing coverge

However, regardless of how long the public health emergency lasts, millions of those who enrolled in Medicaid coverage during the COVID-19 pandemic are on the brink of losing that coverage, after the omnibus spending bill enacted by Congress in December changed the enrollment rules.

States that received extra Medicaid funding under a 2020 COVID-19 relief bill had to agree to pause beneficiaries’ eligibility verifications. The continuous enrollment in Medicare was set to end when the public health emergency is over, which is likely to happen sometime in 2023. Known as The Great Unwinding, the undoing of many health coverage requirements and incentives put into place as a result of the COVID-19 public health emergency declaration and related legislation will be undone when the public health emergency is over.

Under the $1.65 trillion federal spending bill approved by Congress in December, states can begin disenrolling people from Medicaid in April even if the public health emergency designation remains in place. Many of those who will lose coverage are likely to qualify for coverage under the Affordable Care Act, according to public-health officials and advocates.

The legislation will sunset a requirement of the COVID-19 public health emergency that prohibited states from booting people off Medicaid. The Biden administration has been under mounting pressure to declare the public health emergency over, with 25 Republican governors asking the president to end it, citing growing concerns about bloated Medicaid enrollment.

As many as 18 million people could lose coverage, according to estimates from the Urban Institute.

This most recent extension of the public health emergency was no surprise, as the HHS secretary had pledged to give state governments and health care stakeholders 60 days notice if the public health emergency were to expire. In November, no such notice was given, and it was assumed that the emergency would be extended in January.

This renewal comes as a more transmissible COVID-19 omicron subvariant makes its way across the Northeast. This subvariant, XBB.1.5, accounts for more than 70% of cases in the Northeast and about 28% nationwide, and is believed to be the most transmissible subvariant of omicron to have been detected so far, though whether it causes more severe illness than previous subvariants is yet to be determined.