May 11, 2023

Based on current COVID-19 trends, the federal Department of Health and Human Services (HHS) is planning for the federal Public Health Emergency (PHE) for COVID-19, declared under Section 319 of the Public Health Services Act, to expire at the end of the day today, May 11, 2023.

HHS Secretary Xavier Becerra’s February 9^th letter to Governors announced the planned end of the COVID-19 PHE, providing 90 days’ notice to states to give communities time to prepare for the transition. On May 9, 2023, HHS released a fact sheet with an update on current flexibilities enabled by the COVID-19 emergency declaration and how they will be impacted by the end of the COVID-19 PHE. As outlined in the HHS fact sheet:

• Access to COVID-19 vaccinations and certain treatments, such as Paxlovid and Lagevrio, will generally not be affected.
• The Food and Drug Administration’s (FDA) Emergency Use Authorization for COVID-19 products will not be affected.
• Major telehealth flexibilities will not be affected.
• The federal whole-of-government response to Long COVID will not change.
• Certain Medicare and Medicaid waivers and broad flexibilities for health care providers are no longer necessary and will end.
• Coverage for COVID-19 testing will change, but the U.S. Government (USG) is maintaining a strong stockpile and distribution channels so that tests remain accessible at no cost in certain community locations, and USG will continue to distribute tests through COVIDtests.gov through the end of May.
• Certain COVID-19 data reporting and surveillance will change.
• The FDA’s ability to detect shortages of critical devices related to COVID-19 will be more limited.
• Public Readiness and Emergency Preparedness Act liability protections will be amended.

Of note, California state laws add six months (through November 11, 2023) to the federal COVID-19 PHE requirements on health plans to continue covering COVID-19 tests, vaccines, and treatment from any licensed provider (in- or out-of-network) with no prior authorization or enrollee cost sharing. After November 11, enrollees can continue to access COVID-19 tests, vaccines and treatment with no prior authorization or cost sharing when they access these services through their health plan’s network. For more details, the California Department of Managed Health Care has released a fact sheet outlining these health care rights.

The expiration of the PHE does not affect the related changes to Medicaid enacted in the Consolidated Appropriations Act of 2023 as reported previously in a CSAC Weekly Bulletin. With the passage of the federal bill, the continuous coverage requirements that paused all Medi-Cal redeterminations since March 2020 were decoupled from the PHE termination date as of April 1, 2023, setting the stage for the resumption of Medi-Cal redeterminations. Guidance documents related to the PHE unwinding from the federal Centers for Medicare & Medicaid Services (CMS) are available here.

Among the effects of ending the federal PHE, according to the White House, would be the termination of Title 42, a public health, social welfare, and civil rights measure that gives the federal government the ability to take emergency action to keep communicable diseases out of the country, and that has limited the inflow of migrants at the border since its invocation in 2020.