WHO ends COVID-19 global health emergency: What to expect next

Even though the COVID-19 public health emergency in the U.S. is scheduled to end May 11, the World Health Organization jumped in today to declare that COVID-19 is no longer a global health emergency.

WHO declared the COVID-19 the outbreak to be a public health emergency of international concern in January 2020, about six weeks before characterizing it as a pandemic. The virus continues to evolve and spread and remains a global health threat, but with cases on the decrease, COVID-19 is at a lower level of concerns, WHO officials said.

Meanwhile, Rochelle Walensky, head of the Centers for Disease Control and Prevention, announced she will resign on June 30,  saying the waning of the COVID-19 pandemic was a good time to make a transition

There have been more than 765 million confirmed Covid-19 cases since the start of the pandemic, according to WHO data. Nearly 7 million people have died. Europe has had the most confirmed cases overall, but the Americas have reported the most deaths. About 1 in 6 total deaths have been in the US.

The U.S. public health emergency ends on May 11.

Some post-health emergency changes to expect

What does this mean for Americans? Here are some policy changes to expect.

1. Coverage of COVID-19 tests without cost sharing. During the public health emergency, enrollees in Medicare, Medicaid, CHIP and private health insurance received coverage of COVID-19 tests and testing-related services without cost sharing (and, for commercial enrollees, without prior authorization requirements). With the conclusion of the emergency comes the end of no-cost COVID-19 testing for many patients, including the eight free at-home tests Medicare beneficiaries and commercially insured patients were eligible to receive each month.
2. Expiration of Section 1135 waivers. Section 1135 waivers relax numerous federal requirements for health care providers that participate in the federal Medicare or Medicaid programs and also for state Medicaid agencies. Among the many “blanket” 1135 waivers issued by the Centers for Medicare & Medicaid Services are waivers that enable alternative sites of care, clinician practice across state lines, staffing flexibilities for hospitals and long-term care facilities, and the ability for hospitals to establish skilled nursing facility “swing beds.”
3. Waiver of the three-day rule. Medicare normally will cover an extended stay in a skilled nursing facility stay only if it follows a hospital inpatient stay of at least three consecutive days. During the public health emergency, CMS waived this three-day requirement. This waiver will expire at the end of the emergency.
4. COBRA coverage: During the national emergency, people leaving group health plans had more than a year to elect COBRA and pay their first premium. However, beginning June 9, 2023, COBRA deadlines will revert to 60 days to elect COBRA and then 45 days to pay the first premium.
5. Employer-sponsored enrollment periods: Special enrollment periods for employer-sponsored health plans will once again be limited to 30 days, or in some cases 60 days. The limited enrollment windows were not applicable during the national emergency, but will return on June 9, 2023.

Some COVID-19 changes will remain the same

However, some health-care changes related to COVID-19 will remain the same after the public health emergency ends.

1. Vaccines and boosters. Consumers will continue to have access to free COVID-19 vaccines and boosters. That is true whether they have original Medicare, a Medicare Advantage plan, a Marketplace plan, Medicaid or coverage through an employer. (Grandfathered health plans, however, do not have to cover the full cost of vaccines). Consumers will need to comply with in-network restrictions to avoid costs, though.
2. Telehealth access. Most consumers with a marketplace plan or employer coverage will experience minimal or no changes to their telehealth access and coverage after the public health emergency ends.

Medicaid unwinding began April 1

Despite the May 11 date for ending the public health emergency, those who became eligible for Medicaid coverage as a result of pandemic-related legislation were still subject to disenrolling from coverage in April.

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.

Under the $1.65 trillion federal spending bill approved by Congress in December, states could 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.

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

The Department of Health and Human Services is providing outreach and guidance to assist states in redetermining the eligibility of their Medicaid beneficiaries. HHS announced it would permit state Affordable Care Act marketplaces to launch a special sign-up window for people who lose Medicaid to help prevent gaps in coverage.