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The nationwide public health emergency is scheduled to end on May 11, bringing with it several changes to state and federal resources.
The health emergency provided a key resource specific to fighting COVID-19 known as “medical countermeasures.” This included tests, vaccines and treatments.
When and how changes take place to the accessibility of these depends largely on one’s insurance status, the state they live in and their age.
Here are some things to keep in mind.
Changes to testing accessibility
The changes to testing accessibility will likely have the most resounding public health effect out of any post-emergency change, according to a policy brief published by the Henry J. Kaiser Family Foundation, a nonprofit that conducts health care research and provides health policy analysis.
This will most likely have “broad implications for the people’s ability to get timely COVID diagnoses or prevent transmission,” the brief said.
It all depends on federal supply
The federal government purchased over-the-counter tests as well as vaccines and treatments, and “as long as the federal supply is available, you cannot be charged for them,” said Jennifer Kates, senior vice president at the family foundation. “When those supplies are up is when challenges will start to arise.”
Some of these resources made available by the emergency will not end on May 11, but “the clock will start ticking,” Kates added.
If you have Medicaid
For those who have Medicaid, over-the-counter tests and polymerase chain reaction (PCR) tests, which are ordered by health care professionals, will be free until September 2024, said Kates.
After that point, coverage of over-the-counter tests will vary by state for Medicaid recipients, who also may face some cost-sharing for PCR tests.
Although ultimately decided by individual insurance companies, it is expected those with private insurance coverage, including people with private Medicare plans, will have to cover some portion of the cost associated with over-the-counter tests after the federal supply is depleted, according to the foundation brief. Uninsured people will have to pay the full costs of any over-the-counter tests or PCR tests they purchase.
What happens when federal supply runs out
When the federal supply of vaccines has run out, they will remain free for most with some form of insurance.
They will also remain free for anyone 18 years old or younger who is under- or uninsured, Medicaid-eligible, American Indian or Alaska Native through the Vaccines For Children program. The program allows any child to get a U.S. Centers for Disease Control and Prevention-recommended vaccine for free.
Adults who are uninsured will have to pay out of pocket for vaccines once the federal supply runs out, Kates said.
U.S. Food and Drug Administration doses
The changes to vaccine accessibility do not apply to doses purchased by the U.S. Food and Drug Administration, which are governed by a different emergency declaration.
As with vaccines and over-the-counter tests, treatments for COVID-19, such as nirmatrelvir and ritonavir, will remain free for everyone as long as the supply purchased by the federal government is still available. Once that supply is gone, those with Medicaid will continue to have free access until September 2024, then people may face some cost-sharing, said Kates.
Most with private insurance have already begun paying for COVID-19 treatments and will continue to do so after the end of the public emergency. Those who are uninsured will likely have to pay full price for treatment after the federal supply is gone.
The Biden administration has stated it will confirm the end of the emergency 60 days before its end date. If that date remains May 11, then that should be mid-March.
What does this all mean for Wisconsin residents?
The Wisconsin Department of Health Services, or DHS, which administers Wisconsin’s Medicaid and BadgerCare Plus programs, is reviewing guidance from the federal Centers for Medicare and Medicaid Services to fully understand the extent of changes caused by the end of the emergency, DHS spokesperson Elizabeth Goodsitt said in an email.
Those seeking the most current information about Wisconsin’s unwinding of benefits can sign up for email updates.
Know the timeline for other resources
The unwinding of many other benefits and resources connected to the pandemic are not tied to the federal emergency. Therefore, these changes, such as those affecting FoodShare benefits and the Medicaid/BadgerCare Plus renewal process, are on different timelines.
How to get help
People can connect with a Covering Wisconsin navigator by calling 608-261-1455 or 414-400-9489 — or by visiting coveringwi.org or wiscovered.com.
Or they can call 2-1-1, a service that helps connect people to resources.