What does the end of the pandemic public health emergency mean for you

President Joe Biden on Monday announced the public and national health emergencies for COVID-19 will end May 11, nearly three years after the pandemic began.

The public health emergency dates back to January 2020 and has been renewed by the Department of Health and Human Services a dozen times, most recently in January. Then-President Donald Trump declared a national health emergency in March 2020.

The emergency declarations allowed millions of people to receive Medicaid, the state and federally funded health coverage program for low-income families and individuals. The Urban Institute, a Washington think tank, estimated in a December report that 18 million people will lose Medicaid coverage within the 14 months after the declarations expire, including 3.2 million children who will transfer to Children’s Health Insurance Programs. An additional 3.8 million people will lose insurance entirely.

The emergency declarations also allowed the government to provide free COVID vaccines, tests, and some treatments to every American. That will change when the declarations expire.

Here’s what you need to know:

Thousands of Pennsylvania and New Jersey residents newly qualified for Medicaid.

Typically people with Medicaid must renew their coverage every year by proving they still meet income requirements. States suspended the plan renewal process during the pandemic but will resume it in April.

Over the next year, people who signed up for Medicaid during the pandemic will receive renewal packets in the mail with instructions about how to ensure their coverage continues, if they’re still income-eligible. Those whose renewal application is denied because they now earn too much to qualify will be able to enroll in private health insurance through the Obamacare marketplaces — Get Covered New Jersey or Pennie.

Vaccines are free for every American and have been throughout the pandemic. That will change.

Pfizer and Moderna already announced that once the public health emergency ends they will charge for vaccines. Pfizer expects to charge $110 to $130 a dose. People without insurance will generally have to pay that to get vaccinated.

Private insurance companies will continue to cover COVID vaccines, though people will need to get shots within their covered network to avoid out-of-pocket costs.

People with Medicaid or Medicare should continue to receive the vaccines for free. The Affordable Care Act requires those programs to cover recommended vaccines without co-pays.

The government is still shipping free COVID tests for now. A household can order four kits at COVIDTests.gov.

People with Medicare can get eight free test kits a month, and the White House also required private insurers to reimburse members for the same number of kits. State Medicaid and CHIP programs also cover the costs of COVID-19 tests.

Without the emergency health declarations, people covered by Medicaid and CHIP will need a doctor’s order to be tested for free, according to the Kaiser Family Foundation, a health-policy nonprofit. Privately insured people could have to pay some out-of-pocket costs for tests.

People without insurance will have to pay for tests.

The federal government still has millions of doses of Paxlovid, a primary treatment for people with COVID, that will continue to be free while that supply lasts, said Ashish Jha, the White House COVID response coordinator, in a Tweet thread Tuesday.

“Over time, we will transition away from US government buying vaccines and treatments to the regular healthcare market,” he said.

Drugs like Paxlovid and Lagevrio, another oral COVID treatment, have not yet received full approval from the Food and Drug Administration, but the agency has made them available through an emergency use authorization (EUA). That won’t affect their availability after the emergency declarations expire, said Matthew Cortland, a senior fellow who handles the disability portfolio for Data for Progress, a national polling firm and think tank. The EUA is a separate declaration from the national and public health emergencies and will continue after those end.

Treatments will solely be available through the commercial market when the government supply runs out. Medicare will cover oral treatments, including those available through an EUA, though Part D, which governs prescription coverage, will likely require some cost sharing, depending on the member’s plan, Kaiser reported.

Medicaid and CHIP will provide free access to treatments into mid-2024, according to the American Rescue Plan Act.

Private insurers are also expected to cover the costs of treatments, though members will likely also have co-pays.

People without insurance or support from other safety-net programs will be responsible for the full costs of COVID treatments.

Virtual appointments were critical in keeping people connected to their doctors during the pandemic.

Medicare and Medicaid agreed to temporarily cover these visits as they would an in-person appointment. Once the health emergency ends, Medicare recipients can permanently use telehealth for behavioral and mental health care, according to the Department of Health and Human Services. They will also be able to use telehealth for other medical services through the end of 2024, unless they live in a rural area, KFF reported.

Most states either made permanent, or plan to adopt, expanded access to telehealth for Medicaid recipients, according to Kaiser Family Foundation.

Doctors and patients both want telehealth to continue, said Jonathan Stallkamp, chief medical officer for Main Line Health, but it is unclear what private insurance will cover when the emergency declarations expire.

“I think most providers would be willing to continue to provide it as long as they are paid appropriately for it,” he said.

Philadelphia continues to require employers to provide workers with COVID 40 paid hours of sick leave in addition to any paid sick time already offered. That is expected to expire at the end of this year independent of the emergency declarations.

Staff reporter Sarah Gantz contributed to this article.