A Slim Majority of Americans Say the COVID-19 Public Health Emergency Is Still Necessary. But Will Biden Let It Expire in 2023?

Nearly three years after the United States declared a public health emergency due to rising COVID-19 infections, the health care community is watching to see if the White House lets it expire in 2023.

The declaration, and the long list of temporary policies that followed, dramatically altered the country’s health system, with changes ranging from the federal government’s coverage of COVID-19 tests, treatments and vaccines to expanding telehealth coverage.

In October, Health and Human Services Secretary Xavier Becerra extended the PHE through Jan. 11, 2023. Expectations are that the Biden administration will extend the PHE at least another 90 days as states were not notified 60 days before termination, a parameter the administration has set.

As officials weigh the future duration of the PHE, Americans are more likely than not to say the emergency declaration is still needed. 

A slim majority of U.S. adults said they think the PHE should still be in effect, while about 2 in 5 said the declaration is no longer necessary, according to a new Morning Consult survey. About 7 in 10 Democrats said the PHE should still be in effect, while roughly 3 in 5 Republicans think it should end.

Additionally, nearly half of adults overall said the emergency declaration should be extended beyond January, while about 2 in 5 said it shouldn’t.

Health policy experts caution that patients may lose health coverage or access to care if certain pandemic-era policies are not made permanent or carefully rolled back after the PHE.

“When the public health emergency does end, there's a lot of actions and steps that need to be taken to really protect the way we've fundamentally changed a lot of parts of our health care system, albeit temporarily,” said Natalie Davis, chief executive and co-founder of United States of Care. “Action will be important whenever that public health emergency does end, and I know a lot of people are anticipating that will be likely in April.”

Edwin Park, who specializes in Medicaid policy as a research professor at Georgetown University’s McCourt School of Public Policy, said there’s a strong possibility the emergency declaration ends next year.

Two temporary changes under the PHE that health organizations have recently focused on are expanded telehealth policies, which helped fuel an explosion in virtual care usage, and prohibiting states from kicking people off Medicaid programs. However, Congress plans to sever both measures from the PHE as part of an omnibus spending bill lawmakers are racing to pass by the end of this week. If the legislation passes in its current form, pandemic-era telehealth policies will extend for two years and states can begin redetermining Medicaid eligibility in April 2023.

Americans are split on paying for COVID-19 vaccines, tests when the government stops covering them

One important factor after the PHE will be maintaining access to and coverage for COVID-19 tests, treatments and vaccines, particularly for communities disproportionately affected by the virus, Davis said.

While some people believe the PHE should end, including Republican members of Congress, hundreds of thousands of COVID-19 cases and thousands of deaths are still reported each week, according to the Centers for Disease Control and Prevention.

The emergency declaration provides coverage over COVID-19 services, but companies can still commercialize their products even if the PHE is extended. The use of COVID-19 tests, treatments and vaccines may drop if people are forced to pay for them, however, the survey shows. 

Fewer than half of adults (46%) said they would not be interested in paying for COVID-19 products, while a nearly equal share said they would.

Pfizer Inc. CEO Albert Bourla said on a November earnings call that the company has priced its COVID-19 vaccine, developed with BioNTech SE, between $110 and $130. Lawmakers have criticized the price — an estimated 10,000% markup over production costs — as “pure and deadly greed.” Meanwhile, Moderna Inc. executives did not give a specific price range on a November earnings call for its version of the vaccine, but the company projected COVID-19 sales for vaccine prices of $64, $82 and $100 in a September investor presentation.

Most people will be able to receive free COVID-19 vaccines even after the sunsetting of the PHE, as Medicare and insurers are required to cover them and uninsured people can receive free vaccines from certain providers, according to the Kaiser Family Foundation. The health research organization said the end of the declaration is likely to have a greater effect on COVID-19 tests and treatments.

Bourla recently highlighted this point, contending that vaccines will be free for Americans as long as insurers are required to cover the shots. Still, costs could be passed on to employers or as higher premiums.

The government’s stockpile of vaccines is also likely to dry up since Congress is not willing to approve additional funding for the shots, including in the recent omnibus legislation.

Davis said the Biden administration can protect patients' access to COVID-19 services by working with government programs, private insurers and employers to ensure they provide adequate health plans and are clear about coverage changes.

“As we move into this next phase — where the commercial market is in charge of all these coverage decisions and access decisions — we really need to make sure that people can depend on their care, can depend on their insurance, and can navigate a health care system where they can get the care that they need and the treatments and testing for COVID,” she said.