This month, the federal government allowed the declaration of a national coronavirus emergency to lapse.
After more than three years and thousands of deaths from COVID-19 in Missouri, the end of the public health emergency heralds a new phase in which the virus is present but less dangerous to the population.
As we move from this historic pandemic phase of COVID-19 to an endemic phase, we still need to be aware of the virus and that it is not going away with today’s end of the public health emergency, said Dr. Mati Hlatshwayo Davis, St. Louis Medical Director.
What does the policy change mean?
The federal government enacted the coronavirus public health emergency in early 2020. The declaration enabled the government to issue some rules aimed at preventing the spread of the coronavirus. The rules included allowing more doctors to confer with patients via computers and cellphones and requiring insurers to offer free tests, vaccines and other treatments for COVID-19 to people in the United States.
It’s almost like a special soapbox, and when the president declares an emergency he gets this soapbox, said Rob Gatter, director of health care law studies at St. Louis University. When he’s on that soapbox, he builds power in the president to be able to take legal authority to take steps that the president doesn’t normally have.
The federal government renewed the public health emergency every 90 days. Department of Health and Human Services officials let it expire on May 11.
There have been multiple emergency declarations at the local, state and federal levels. Governor Mike Parson more than a year ago announced the end of the coronavirus crisis in Missouri. The state emergency expired in April 2022.
The deadline meant that health care workers licensed in other states could no longer work in Missouri and that the National Guard would no longer conduct vaccination campaigns and other duties related to the coronavirus pandemic
The federal public health emergency was more far-reaching and dictated different dispositions across the country.
How will the end of the emergency affect tests and vaccinations?
One of the biggest changes will be potentially higher costs for vaccines and tests. During the public health emergency, the federal government required insurers to offer them free to everyone. This will continue, but it is unclear how long these arrangements will last.
The federal government still hands out free shots and boosters to local clinics and health departments, but free federal vaccine coverage depends on government provision, so health officials are encouraging people to get shots or boosters as soon as possible. In the St. Louis region, people can still be vaccinated at St. Louis County public health clinics.
We strive to continue working as we have for the past three years to provide access to COVID-19 mitigation methods, including vaccines and testing, through our clinics and partnerships, said Dr. Kanika Cunningham, Chief Medical Officer of St. Louis County.
The cost to patients will ultimately depend on a person’s insurance coverage, Gatter said. Some insurers may treat the COVID-19 vaccine as an annual flu shot, which patients can often get for free.
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St. Louis Public Radio
The short answer is, you probably aren’t able to get it out of your pocket for free, Gatter said. When that ends, it’s treated more like any other type of test or vaccination you might get. If your health plan already covered various forms of vaccinations at no cost to you, you may still have that benefit. But it is no longer a requirement.
Doctors will likely continue to meet patients via telehealth, he said. Recently passed federal laws will keep much access to telehealth at least through 2024, federal officials said. Before the pandemic, patients often needed access to telehealth on specific secure devices. Many patients are now accessing virtual appointments on their laptops or phones.
Will the change affect Medicaid for Missouri patients?
Missouri has made more than 200,000 people eligible for Medicaid during the pandemic. But it is not related to the public health emergency.
First, let me say that even though Missouri expanded access to Medicaid during the pandemic, it wasn’t the result of an emergency requirement, Gatter said. It’s here, and it’s here to stay.
But the federal government has prohibited Missouri and other states from kicking people off Medicaid during the public health emergency. This led to a pause on annual renewals required for patients enrolled in the Health Insurance Program for Low-Income Missourians and their Families.
Federal officials separated that requirement from the public health emergency earlier this year. That means the state has started requiring people to submit annual renewal paperwork to maintain coverage. Since many new Medicaid patients have never had to renew their coverage, it is possible thousands could inadvertently lose their coverage.
So if someone became a Medicaid beneficiary as a result of Medicaid’s expansion during the pandemic, or joined Medicaid at the start of the pandemic, they never had to gain experience to ensure they stayed enrolled, and now they will. said Gatter.
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St. Louis Public Radio
Does this mean that the coronavirus is less dangerous?
The end of the filing is not the end of the risk associated with COVID, Gatter said.
As people have to pay for vaccines and testing, the disease burden is likely to continue to disproportionately hit uninsured and poor people without sick leave, he said.
This will continue to be a risk. And even if the numbers are lower, we’re likely to see this differentiation. And I think the telltale sign will come this fall and winter, Gatter said.
Although coronavirus-related hospitalizations, deaths and cases are at the lowest rates in Missouri since the pandemic began, it is incorrect to refer to the virus as an endemic or consistently present disease, said Dr. Hilary Babcock, a physician at infectious diseases and chief quality officer for BJC Healthcare.
I think we’re in this sort of weird range between pandemic and endemic, he said.
Influenza and other endemic viruses fall in a predictable pattern of rise and fall, something epidemiologists cannot yet predict about the coronavirus, he said. Missouri and other states with below-average vaccination rates could be hit harder by future outbreaks than other states.
I think my concern for Missouri and some other states that have been a little less willing to accept security measures for a longer time, a little less willing to change their behavior, in the long run is whether they are ready to react in response peaks in progress, Babcock said.
When the number of cases rises, people can wear masks and practice social distancing to protect themselves, he said.
Emotionally, it’s a little weird, we don’t really get the opportunity to say it’s over, Babcock said. We can look back, we can mourn those we’ve lost, we can think about how we can do it better in the future. Because there is no clear line where we can tell what time it is done.
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