Public Health Emergency expected to be extended

HHS had a deadline of May 16 to notify the public that the Public Health Emergency would end in 60 days. Because the deadline has come and gone with no word, it is expected that the PHE will be extended past the current July 16 end date, but how far is unknown.

The American Medical Association in conjunction with the American Nurses Association and the American Hospital Association wrote Department of Health and Human Services Secretary Xavier Becerra lobbying for another renewal.

Becerra told health care leaders after the first extension that he would give them a 60-day warning if it will not be renewed.

The PHE removed many barriers to telehealth, allowing Medicare reimbursement and elimination of various site and security requirements, giving doctors and patients the ability to use whatever technology they had access to. While the Biden administration has pushed to make some of these changes permanent, congressional action is required.

While much of the country has moved on as if the pandemic was over, the CDC shows a rising number of cases in recent weeks, with a rise in hospitalizations, as well. These rising numbers concern the professional medical groups, who point out that new variants may emerge that strain hospital and health systems.

The end of the PHE will have far-reaching effects across the health system. For example, all states will need to reassess Medicaid eligibility resulting in a projected 13 million to 16 million people losing their coverage. Up to one-third of those may be eligible for a subsidized marketplace health plan, but getting them moved to the new program presents massive challenges to Medicaid officials because of the sheer volume of people. Planning is difficult, because there is uncertainty as to when the PHE will end. Officials will need to determine eligibility requirements and direct people to the appropriate program.

Fifteen million or more current Medicaid enrollees will potentially be ineligible for Medicaid at the end of the PHE, so states face a monumental task catching up on delayed renewals and redeterminations, according to a report from the Robert Woods Johnson Foundation. A lack of funding is expected to hamper this effort in many states, and those that have funding don’t want to hire staff until there is work to be done, but no one knows when that will start. Staff training is needed beforehand, but with no known start date for the end of PHE, timing is difficult for Medicaid officials.

Another challenge for state officials, according to the report, is to reduce the number of people who fall through the cracks and become uninsured. People will need targeted messaging to direct them to the right plan and program, and states aren’t always successful with their messaging. When confronted with an overwhelming volume of complicated plan choices, many consumers make no decision at all.

Another concern is that Marketplace plans have narrow provider networks that may be inadequate to meet the needs of the large influx of new enrollees. If a large share of people in a given service area gravitate to just one or two narrow-network plans in a short period of time, they may face delays or difficulties accessing timely appointments for needed services, according to the report.

Originally published on our sister brand, Medical Economics.