Covid emergency’s end will mean new costs, hassles

Key changes Americans can expect:

— Many will have to pay for Covid-19 vaccines, tests and treatments. People without health insurance will have to pay out of pocket, while those with private plans could see more costs depending on the terms of their insurance. Insurers typically cover the costs of preventive care, such as vaccines, but often charge deductibles or require cost-sharing for drugs.

— Medicare, Medicaid and Children’s Health Insurance Program beneficiaries could also face more cost-sharing for tests and some Covid antivirals, though vaccines will remain free.

— Employers will no longer be able to offer telehealth access as a premium, tax-free benefit separate from other health plans.

— Eased rules for prescribing controlled substances without an in-person doctor’s visit could also end unless the Drug Enforcement Administration moves to extend them. That could affect people seeking mental health care, transgender care, treatment for opioid use disorder, and even for severe coughs.

— Medicare coverage requirements that were waived during the emergency will now resume. For example, Medicare patients seeking admission to a skilled nursing facility will first have to spend three days in a hospital.

— The Medicare prescription drug benefit will no longer allow patients to get extended supplies of many drugs.

— Medicaid and CHIP coverage will change in some ways, as state and federal agencies made changes — such as boosting provider payments, increasing beneficiary access to medicines and expanding some covered services — to their programs because of the emergency. Some of those changes, though, can continue after the end of the emergency, depending on the state and policy.

— Hospitals will lose the 20 percent increase in Medicare payments they’ve received for treating Covid patients.

Nutrition assistance

— Work requirements for federal food assistance programs that were paused during the pandemic will return in more than two dozen, mostly Republican-controlled states that haven’t waived the requirements.

— Other administrative rules that helped people receive their Supplemental Nutrition Assistance Program benefits will also end.

Immigration

— The White House said the end of the emergency would also end Title 42, a health policy used at the start of the pandemic to shut down the southern border by denying immigrants the opportunity to request asylum. But Republicans in Congress have argued that the policy is not tied to the public health emergency.

What Biden’s decision on the emergencies won’t change:

— Medicare patients and people in high-deductible health plans will continue to have eased access to telehealth through the end of 2024 because of an extension Congress included in the year-end spending bill.

— Lawmakers also agreed in that legislation to wind down beginning in February extra SNAP food assistance that was offered during the pandemic.

— A requirement that states allow people to stay enrolled in Medicaid regardless of their eligibility for the program will end in April, allowing states to kick millions off the rolls. Many of those affected, whose incomes are now too high to qualify for Medicaid, will be eligible for low-cost Obamacare plans.

— The FDA will continue to have the power to authorize vaccines, tests and drugs on an emergency basis.