The U.S. Public Health Emergency (PHE) that began at the start of the COVID-19 pandemic concluded on May 11, 2023, ending the temporary policies started in response to the pandemic. These changes have affected the American public in different ways. For those with Medicare, over-the-counter COVID-19 tests are no longer free, and coverage regarding COVID-19 testing and treatment will change depending on the insurance plan. Another change that comes with the termination of the PHE is that COVID-19 vaccines and boosters will continue to be free, but only until the federal stockpile lasts. While these changes might seem obvious as COVID is not as prominent as it once used to be, there are some changes that have negatively impacted underserving a community’s way beyond COVID-19 coverage.
One of these changes includes Medicaid redeterminations restarting. Continued Medicaid enrollment ended March 31, 2023, and states have restarted Medicaid and Children’s Health Insurance Program (CHIP) edibility reviews. Some patients that usually do not qualify for Medicaid, did qualify during the PHE period. This means that these patients have the dreadful task of finding and transitioning to another type of insurance. Unfortunately, the only insurance option was Medicaid for some of these patients, as they could not afford anything else.
A direct consequence of the end of the PHE will be the looming loss of Medicaid eligibility for the millions of Americans who come from low-income households. There could be as many as eighteen million enrollees without coverage as a result of the new eligibility requirements. The U.S. Department of Health and Human Services predicts that people of color will lose coverage because of administrative barriers, not because they don’t qualify in many instances.
The end of PHE will affect more Black and Hispanic communities since they are twice as likely to be Medicaid recipients. This sudden cut in coverage will only worsen an already failing healthcare system for people of color; this is because the cut in coverage will reduce access to screenings and preventive care for chronic diseases that are more common in people of color, overload already overburdened hospitals with emergency care, and cripple low-income families with medical debt.
To avoid or lessen all of these inequalities in the healthcare system, states must act as soon as possible. For example, states can market campaigns to encourage citizens to sign up for alternative care that has COVID-19 benefits, as well as communicate with Medicare enrollees so that they at least know their coverage is coming to an end. The state of Colorado has already taken a proactive approach to healthcare insurance by opening enrollment for a program called OmniSalud that assists undocumented residents and individuals with protections through the Deferred Action for Childhood Arrivals program in obtaining affordable healthcare insurance. Communities that lack these kinds of programs should follow suit and protect their most vulnerable residents.
It is an overstatement to say that COVID has ended when it has not. It is important to remember that moving out of an emergency state does not mean the impact on vulnerable communities has concluded. It is imperative that states enact policies that prevent the worsening of COVID-induced inequities in the most vulnerable communities.