Ending the public health emergency means an end to free COVID testing

The end of the COVID-19 public health emergency on May 11 will mark the end of an era in the US health care system, as many Americans will have to pay for care that for the past three years has been free.

Experts said the changes related to the public health emergency would not be earth-shaking. When the public health emergency ends, the biggest change facing the majority of Americans will be that the days of free, readily available testing for COVID-19 will likely be over.

Currently, anyone with private insurance can get up to eight tests a month. This will disappear after the emergency is over. Private insurance may no longer cover the full cost of over-the-counter tests, and patients may first need a prescription for a PCR test.

Vaccines and treatments will continue to be free as long as the government supply is sufficient.

“On May 12, you can still walk into a pharmacy and get your bivalent vaccine. Free of charge. On May 12th, if you get COVID, you can still get your Paxlovid. Free of charge. None of this changes,” White House COVID-19 Response Coordinator Ashish Jha tweeted Wednesday.

Jen Cates, senior vice president of the Kaiser Family Foundation, said the end of the public health emergency will be mostly symbolic. The nation still faces 400 to 500 COVID-related deaths per day and low vaccination rates.

“It will send a signal. Some people will hear this and say I don’t have to worry about COVID anymore. And that’s actually not true. It doesn’t work like that,” Cates said.

The flexibility afforded by the Public Health Emergency (PHE) has affected almost every aspect of the US health care system, and it will not be easy to relax it, although recent legislation has made some of the most disruptive changes apart from the end of the emergency situation.

For example, the requirement that states allow people to remain enrolled in Medicaid regardless of eligibility will end in April. And Congress separately extended easier access to telehealth services through the end of 2024.

“I think inevitably there will be some mess. I think there’s no way to avoid that aspect of it,” Cates said.

“The changes that were made were essentially, if you look at them as a whole, the closest we’ve probably gotten to universal health coverage in the United States. There’s cost sharing, there’s network issues, there’s deductibles. All of that was taken away … to protect people, to allow providers to have more flexibility,” Cates said.

The biggest shock to society is likely to come once federal supplies of vaccines and treatments are exhausted and costs are shifted to the private sector.

Vaccines will still be free for people with private insurance, although the cost will likely be reflected in premiums. Even with insurance, patients will likely see costs if they go to an out-of-network provider.

Treatments like Paxlovid will also be available with cost-sharing for people with private insurance.

The White House is urging Congress to provide billions more in funding to pay for a steady supply of vaccines and treatments against COVID-19, but lawmakers have shown no appetite for it.

The administration is coordinating with manufacturers to make sure they have enough tests, treatments and vaccines available to hit the commercial market when the government’s involvement ends.

But uninsured adults won’t have guaranteed access to testing or treatment, though Jha indicated the administration is working on a plan.

“We are committed to ensuring that vaccines and treatments are accessible and not too expensive for uninsured Americans,” Jha said. “When PHE ends, access to free vaccines and treatments does not go away. And over time, as we transition this into the mainstream health care system, we’ll make sure that vaccines and treatments for COVID remain affordable and accessible to Americans.”

Pfizer executives said the company expects to quadruple the price of its COVID-19 vaccine and charge between $110 and $130 per dose after the government contract ends. Moderna proposed a similar price increase.

Eli Lilly’s monoclonal antibody treatment is now sold directly to suppliers at a list price of $2,100 per dose, although it may not be effective against some of the newer omicron subtypes.

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