This Little Pandemic Went to Market

Starting on May 11, President Biden is ENDING the emergency COVID-19 regulations that have been in place since the start of the pandemic in January 2020. These regulations created (almost) a Medicare for All-type public funding system for vaccines, testing, and COVID-related care. While the pandemic itself is still raging, the end of the official Public Health Emergency (PHE) means that access to COVID prevention and care will become like any other form of care in the U.S.: whatever you can get through the private market. That means prices going up, highly inequitable access, and millions of us falling through the cracks. In addition, the public health emergency added crucially important protections for Medicaid enrollees, millions of whom will start getting kicked off their insurance in April. Brace yourself for a major healthcare catastrophe a couple of months from now.

Show Notes

The COVID-19 pandemic is still happening

According to CDC:

  • Still an Average of 40,404 new cases per week (and these numbers are surely an undercount considering how few cases are actually reported to a public health agency.)
  • Still an average of 3,665 hospital admissions per week
  • Still an average of 453 deaths per day
  • Still a lot worse than flu! Among the 2,398 Pneumonia, Influenza, and Covid deaths reported for this week, 998 had COVID-19 listed as an underlying or contributing cause of death on the death certificate, and 50 listed influenza.

According to William Hanage, epidemiology professor from Harvard: “It’s beyond question that society has moved into a stage where the pandemic is for most of us if not over then certainly quiet. And that’s a great thing. Long may it remain so. Is it the case that there is no preventable suffering? No. There is still preventable suffering and death.”

Why end the Public Health Emergency when the virus is still raging?

We all wish COVID-19 would go away. President Joe Biden’s announcement Monday January 30th that his administration would end the PHE along with a separate COVID-19 national emergency in May, winding down services and supports.

The Public Health Emergency has been really inconvenient for Republicans, so they voted for a bill in the House to end the PHE immediately.

With either approach, the gradual wind-down or the abrupt end, there is no way to legislate ending the pandemic. Germs don’t care about politics. What’s really ending is the public health safety net for preventing and treating COVID.

What were the emergency regulations, and what are the real-life consequences of ending them a few months from now?

Let’s start with the single most important thing that’s going to happen: an estimated 15 million people are going to get kicked off of Medicaid starting in April. That’s about 4.5% of the entire population of the United States. When COVID struck, the federal government essentially banned states from kicking people off of Medicaid. People get churned off of Medicaid shockingly frequently – maybe because you started earning just a little too much money, or you moved and your re-determination paperwork went to your old address, or a million other reasons. This mostly stopped during the pandemic, and Medicaid’s enrollment rose – the federal government also provided increased funding to states to pay for the increased enrollment.

The next regulation that’s ending has to do with our old friend, Medicare Advantage plans. We’ve talked a lot about how privatized, for-profit Medicare Advantage plans have extremely limited networks, making it hard to get the care you need without having to travel ridiculous distances. During the COVID emergency Advantage plans were required to cover COVID-related treatments at ALL providers as in-network care. That’s going to end starting in May, and if you see the wrong provider for COVID care, you could get slammed with a huge bill.

What about COVID tests?

You will no longer be able to order free at-home tests from the government, from Medicare, or your private insurer (unless they decide they want to cover that – hah). These home-tests are surprisingly expensive, and that’s going to be a new out-of-pocket cost for almost all Americans now. We were big fans of the chance to write to the government, and they would quickly send you something you need. What a novelty!

If you get a COVID test from a provider (a doctor or a hospital), it will be covered by your insurance if you have insurance, but insurers might start to charge a co-pay for these tests, or they could even limit the number of tests you can get per year. If you don’t have insurance the government will pay for the test, but they obviously won’t pay for your doctor’s visit or hospital visit, so uninsured people will face the same disincentive to seek care when they get COVID as they do with other illnesses and injuries.

Treatment for COVID

We basically had a “Medicare for All Treatment of COVID” system in place the past few years. After May 11, if you come down with COVID and need to be treated, these are now going to be like any other illness. If you have insurance, you will likely face co-pays for treatment or hospitalization. However, if you need access to a drug like Paxlovid that is purchased by the federal government, that drug will still be free regardless of insurance coverage. However, uninsured people will have no coverage of all their other COVID-related care, so it’s small comfort to have a prescription drug covered as a result of that care.

How about vaccines?

There won’t be that much of a change. Since vaccines were rolled out, the feds have been buying them in bulk from the manufacturers and distributing them to anyone regardless of insurance status. But Moderna and Pfizer are still planning on jacking up their prices for vaccines so that could be a budget concern for the feds– and could have consequences for the medium to long-term future. Federal vaccine supply seems to be ok for now, but it’s unclear how the price increases will affect future bulk purchases.

Friend of the movement Senator Bernie Sanders, in his role as Chair of the Senate Health, Education, Labor & Pensions (HELP) Committee has been demanding accountability from the vaccine manufacturers, who have already made massive profits off the pandemic. He’ll be holding a hearing in March about the potential quadrupling of vaccine prices.

Is there a silver lining?

Part of the PHE was something called Title 42, which allowed former President Trump to use the pandemic as an excuse to close the Southern border.

“The policy, introduced by the Trump administration in March 2020, has been used to expel migrants — including many asylum seekers — about 2.5 million times.”

Funny story – if Republicans had their way and ended the COVID emergency immediately, they would have also immediately ended the Trump-era COVID restrictions on immigration, which would have meant welcoming millions of new immigrants across the border. So good on Republicans for accidentally trying to do the right thing.

Despite that bright spot, it sounds like the consequences for most folks are going to be pretty shitty?

For a minute, we were treating COVID like a public health emergency, but now we’re going back to our old standby for healthcare in this country: Market based-solutions. And whenever that happens, we get fucked.

For folks who are interested in how we get our current healthcare system unfucked, our annual Medicare for All conference is coming up! This year’s conference, “Everybody In: Racial Equity & Medicare for All.” The conference will take place ONLINE from April 17-23, 2023, and will include a week of evening events followed by a weekend of live workshops. Whether you are an experienced activist or just looking to learn and get involved for the first time, this is the conference for you! Stay tuned for updates and info on how to register.

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