Biden Extends Covid Public Health Emergency While States Move On

The federal public health emergency for Covid-19 will be in effect for at least the next 60 days, with Department of Health and Human Services officials not yet signaling an end date.

The Biden administration has promised to give states 60 days’ notice when a decision is reached. The current declaration ends in mid-January, a time that health policy experts mark as risky for the administration to relinquish regulatory flexibility given projected increases in Covid-19 infections, the flu and the respiratory syncytial virus, or RSV.

“We’re already seeing obviously tremendous strain on the healthcare system right now,” said Wendy Parmet, a Northeastern University law professor. “We seem to be at the cusp of what might be the tripledemic. I think there’s probably a lot of concern at HHS that the situation may get worse before it gets better.”

President Joe Biden himself has remarked that the nation’s Covid response is shifting, possibly reaching an end for the emergency declaration.

Sarah Lovenheim, assistant secretary for public affairs at HHS, said in a statement Monday that the emergency “remains in effect and as HHS committed to earlier, we will provide a 60-day notice to states before any possible termination or expiration.”

Ending the emergency, a formal declaration by HHS, has far-reaching implications for health policy and the Biden administration’s efforts to slow the spread of the virus.

“Once the public health emergency is lifted and all the regulatory flexibilities start to get unwound, it would be nearly impossible to reverse course and put the genie back in the bottle,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.

The emergency powers help the government put Covid vaccines on a fast track, loosen health care regulations, and greatly expand the amount of Medicaid funds going to states. Ending them means states could start removing people from their Medicaid rolls, likely leaving some uninsured.

“With the public health emergency extended past mid-January, there could be a debate in Congress about accelerating some of the unwinding, including the continuous coverage requirement in Medicaid. That might produce budgetary savings that could be used for other priorities,” Levitt said.

The average for daily new Covid cases in the US has remained below 50,000 since early October, less than the 80,000 average daily for this time last year, Centers for Disease Control and Prevention data show. However, public health groups and Biden administration officials have warned a wave of new cases could come this winter and that current Covid case counts could be missing those who only use at-home tests.

Should the public health emergency expire and states start dropping people from Medicaid, it would come at “the worst time for hospitals” given issues like staffing shortages and longer wait times, Parmet said.

“January is a really bad time,” she said. “The hospital system may be under significant stress.”