By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
I have said more times than I can count, “I wouldn’t wish COVID on my worst enemy.” I am still stunned by the ferocity of that virus and the damage and suffering it caused before the vaccine was available and the disease mutated into the Omicron strains. For most people it’s not as ferocious now, but COVID continues to cause horrible damage and suffering with the disease itself, long-COVID syndromes, and post-COVID syndromes in far too many people. I so wish that COVID, like its cousins the SARS viruses of the 90’s and early 2000’s, would have disappeared. But that is not the case. COVID it seems, like the flu, will be with us forever.
Last week, the White House announced they will be ending the COVID national emergency and public health emergency declarations on May 11th. That is a major step in transitioning COVID from pandemic (wide-spread unmanageable surges) to endemic (something we live with and can manage). While endemic means it is something we live with, that the experts feel its not something that is likely to be as out of control as COVID was in the early stages is a really great thing. So, it is a big positive that the emergency declaration is ending.
In terms of what that means for all of us day-to-day, is a lessening of governmental involvement in managing the disease across populations and more involvement by individuals when it comes to COVID, just like with all of the other transmissible diseases we deal with. For instance, right now, how expenses and payment for COVID-related services is highly controlled by the federal government. Once
the emergency declaration is over, a COVID diagnosis will be treated like any other diagnosis. Payment for services will depend on a person’s insurance coverage.
While none of this is certain, experts are predicting this is how services will change after the emergency declarations expire. The ability to order free at home tests at COVIDtests.gov will go away. Medicaid testing is likely to stay free until 2024, Medicare will likely eliminate free at home testing, and for people who have private insurance, free testing will depend on the state and the insurance carrier. PCR testing, which is considered the gold standard for COVID testing, currently costs around $100 per test.
Vaccines will also change with Medicaid continuing to supply free vaccines, with no projected end date, Medicare has not announced how they will handle COVID vaccine cost. For private insurers, like with testing, it will depend on the state and the insurance carrier. While neither Pfizer-BioNTech or Moderna has given an exact price, experts are estimating the vaccines will cost between $110 and $130/dose.
Both Medicare and Medicaid will continue to cover Paxlovid through 2024, but as most other treatments are not FDA approved, those are not covered by Medicare or Medicaid at this point. Private insurers again will depend on state and the insurance carrier.
One of the good things that came with COVID is the rise of telehealth. The emergency created a window that stopped geographic restrictions and improved payments for those services. Once the emergency is lifted, telehealth regulations may go back to previous rules which will depend largely on
state regulations. Experts on health care disparities worry about how this will affect rural health care especially with so many rural facilities having lost services or closed altogether during the pandemic.
In addition, Medicaid coverage reviews, which were suspended during the pandemic will resume which may mean people who currently have Medicaid coverage will lose that coverage once the reviews resume. Finally, hospital funding which was tied to COVID survival rates will also likely go away.
Again, all of this is not finalized, but the major consensus among experts is COVID resource allocation is going to change dramatically. That means that all of us will have more choices, but it also means we will have more individual responsibility. The emergency going away does not mean COVID is going away. It is still out there, and its still not anything I would wish on my worst enemy. Please make sure you are continuing to take precautions against COVID, just as you do with flu and other illnesses. Please continue to wash your hands, stay home when you are sick, and visit with your primary care provider about vaccinations and other measures to prevent both your ability to get COVID and other transmissible diseases and pass them along.