The end of the federal Covid-19 public health emergency on Thursday marks the end of an era for the American health system.
For more than three years, in a nation where patients usually pay more for health care than residents of any other high-income country, tests and vaccines have been available to all Americans for free. Treatment has been free for many people, too, including those without insurance.
Health care providers adapted on the fly, moving services to the computer or the phone in order to continue treating patients. Hospitals got an important infusion of government funding at a time when, at least at first, they were forced to cancel many of their surgeries and other services in order to handle surges of patients as the coronavirus spread.
But now that the emergency is ending, many of those provisions will cease. Others, extended by Congress recently, will have a limited life span unless lawmakers decide to act again — something that seems unlikely as the political debate moves on and with the GOP in control of the House.
American health care is, like everything else, getting back to normal — which means it will be harder for some people to access the health care they need.
“As we transition into the new normal, we are returning mostly to our fragmented health system as we knew it,” Jen Kates, director of global health at the Kaiser Family Foundation, which has analyzed the implications of the emergency’s end, told me.
The most important pandemic provision that is winding down is Medicaid’s policy of continuous coverage. Usually, states regularly check whether people enrolled in Medicaid are still eligible for it. But with additional federal funding, states kept everyone on the rolls throughout the pandemic. Those eligibility checks have now resumed, and millions of Americans are expected to lose their health coverage over the course of the year — whether or not they should. There are already reports of Medicaid enrollees navigating…
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