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What Happens When the Public Health Emergency Ends?

The Secretary of the Dept. of Health and Human Services declared a public health emergency (PHE) in January 2020. The authority for this declaration is found in Section 319 of the Public Health Service Act, and it allows the Secretary to suspend or amend various regulations to facilitate responses to the emergency.

First, recall two administrations have been involved with the PHE. Secretary Alex Azar, who served during the Trump Administration, issued the first emergency declaration in early 2020, followed by President Trump’s declaration of an emergency in accordance with the provisions of the National Emergencies Act. Secretary Xavier Becerra, the current HHS Secretary, has continued to extend the PHE. The current extension expires this month but will certainly be extended one more time for 90 days, as President Biden promised to give states at least 60-days’ notice before ending the emergency.

The declaration of a PHE can temporarily suspend rules and alter payment systems and eligibility criteria. The end of the emergency sets the rules back to the status quo ante the pandemic. However, it’s not an all-or-nothing situation. Already, the Secretary of HHS has reinstated some of the provisions of regulations that were waived earlier.

Let’s consider some of the most relevant effects of the various emergency declarations, what they achieved, and how their expiration might impact our healthcare system.

Medicaid Provisions

One of the most important provisions of the PHE declaration has been to ensure universal coverage of testing and vaccination against the COVID-19 virus by requiring Medicaid to make testing and immunization available at no cost to the member. The provision applies to Medicaid recipients as well as uninsured people who can access testing and vaccination through Medicaid. When the PHE expires, individual states can maintain this benefit, but the uninsured will no longer have mandated access to free testing and immunization.

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