Here’s How That May Affect You

Topline

The Covid Public Health Emergency ends Thursday, changing the way the CDC tracks Covid data, potentially impacting how the transgender community receives treatment and raising the potential for the public to pay for tests, vaccines and treatment.

Key Facts

Data Reporting

The CDC has kept a tracker of Covid cases, deaths, vaccinations and hospitalizations since the beginning of the pandemic through lab reporting from states. However, once the PHE is lifted, the requirement for the collection of this public health data will end. States will no longer be required to report vaccine information, which makes it harder for the federal government to get an accurate count of national vaccine numbers and effectiveness. The CDC has been working with states to sign voluntary data use agreements to encourage the sharing of data at least through the end of the year. However, hospitals are required to report some data through the end of April 2024, though it will be done on a weekly basis instead of daily. The National Vital Statistics System will also report Covid deaths weekly instead of daily. “The CDC is shuffling Covid into the deck of infectious diseases that we’re satisfied living with,” Sam Scarpino, a public health expert at Northeastern University, told the New York Times in regards to the lack of Covid tracking.

Covid Tests

Covid tests will no longer be free, and insurance companies will no longer be required to provide free tests or waive costs, though some may still cover it. Under the PHE, insurers were required to cover up to eight free at-home tests a person per month. Those on Medicaid will still have access to testing services through September 2024. Free tests are still available at COVIDTests.gov through the end of May. PCR tests administered by public health officials will remain free for most of the insured, but the accompanying doctor’s visit may come with costs. Those on Medicaid will still have access to testing services through September 2024. However, the Increasing Community Access to Testing (ICATT) program will continue providing free Covid tests to the uninsured. A recent report from the CDC found one-third of U.S. households used free at-home Covid tests from the White House program that sent them out via mail. The study also found that without the kits, one in four adults who used a test would have likely gone untested.

Covid Treatment

As long as Covid medications, like antiviral Paxlovid, are purchased by the federal government, Medicare patients won’t be required to pay for them. After that’s over, the price will be determined by the medicine’s manufacturer, and coverage handled through insurers. For older Medicare patients on Part D coverage plans (which most are), all FDA-allowed medicines will be covered, though cost-sharing and limited coverage may arise. Medicaid and CHIP programs will continue covering the cost of pharmaceutical treatments through September 2024. After that, treatment may still be covered, though states may place utilization limits and nominal cost-sharing. Any federally purchased pharmaceutical treatments will be free to all regardless of insurance coverage. The U.S. government has millions of doses of oral antiviral treatments, which are predicted to last for the next few months. However, once those are gone, the manufacturers will determine cost, and the price people pay out-of-pocket will be determined by their insurance.

Covid Vaccines

Covid vaccines and boosters will remain free for insured and uninsured Americans. This is because the cost and availability of vaccines is determined by the federal government’s supply, not the PHE. So as long as federally purchased vaccines last, Covid vaccines will remain free. Once the federal vaccine program switches to the private market, which is expected to happen in the fall, vaccines will remain free for most of the insured. For the uninsured, Biden announced the $1.1 billion Bridge Access Program in April to give free access to Covid vaccines through December 2024. Under the Public Readiness and Emergency Preparedness (PREP) Act, more medical professionals, like pharmacy interns, pharmacists and pharmacy technicians, are able to administer Covid vaccines, flu shots and routine childhood immunizations to kids as young as three. This is set to extend until December 2024, but once lifted, children will no longer be able to receive these shots at pharmacies and will have to get them from healthcare providers.

Telehealth And Gender-Affirming Care

The Drug Enforcement Administration issued an extension on “the full set of telemedicine flexibilities,” through November 11, 2023. For any patient-doctor telehealth relationship established by that date, telemedicine flexibilities for prescriptions of controlled drugs like Adderall or Xanax, will be extended through November 11, 2024. For those on Medicare, telehealth services will be available through the end of 2024 due to a bill signed into Congress in 2022. For those on Medicaid, most telehealth appointments were covered prior to the PHE, and will remain once it’s lifted. Telehealth services have been vital in gender-affirming care for the transgender community, especially those in care deserts, by decreasing travel time, expanding access and providing safety. A recent study published in the Journal of Telemedicine and Telecare looked at the work a children’s hospital did with transgender youths and found the gender-affirming services offered to the youth through telehealth was “lifesaving” and should be offered “as part of the standard of care.” A report by Axios found the end of the PHE could spell trouble for transgender men, as the requirement for in-person visits in order to continue treatment may delay the patient’s transition process or reverse changes the body underwent. This is because testosterone has been labeled as a controlled substance since the 1990s, so once the extension is lifted, patients will be required to meet doctors in-person in order to continue testosterone treatment. Estrogen treatments won’t be affected. Dallas Ducar, CEO of TransHealth, a Massachusetts-based transgender clinic, told the 19th News “Any rule that requires any type of evaluation in person of trans and gender-diverse individuals will result in significant harm, because we’ll see access to gender-affirming care decline.”

Further Reading

WHO Ends Covid’s Global Health Emergency Status After More Than 3 Years (Forbes)

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