What impact will the end of the COVID emergency have on your family?

COVID is over — or at least the national emergency declaration is.

However, the effects of the disease — which kills several York countians each week — linger. So do concerns about access to health care that was extended as part of the initial response to the pandemic.

President Joe Biden signed a bill Monday to end the COVID emergency declaration issued by his predecessor, Donald Trump. That was a largely bureaucratic move, according to local public health officials. The more impactful development, the previously announced lifting of a public health emergency, will come May 11.

"The downside is that some policies, flexibilities and funds that enabled our response to the COVID pandemic are available because of the public health emergency declaration," said Dr. Oluwatomi Uwazota, medical director of the York City Bureau of Health. "How we support the community will look different with this upcoming change."

Uwazota said one of the concerns for the patients the Bureau of Health serves is the risk of losing health insurance and other benefits due to the loss of continuous coverage requirements for those who have Medicaid or CHIP.

She encouraged people to update their enrollment information with the state at https://www.dhs.pa.gov/Compass if still eligible, and to seek other low-cost coverage options through https://www.dhs.pa.gov/chip/Pages/CHIP.aspx and https://pennie.com/. 

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The Bureau of Health will also give out COVID-19 test kits at the clinic and community events while supplies last.

When the public health emergency expires, it will have an impact on the pricing of at-home COVID tests. While some private insurers may continue to cover all or some home tests, there will be no longer be a nationwide rule. A two-pack of tests typically costs between $20 and $24.

“What we will see is a hodgepodge of approaches by different insurance companies, which is going to make it difficult for individuals to know what they’re going to be paying,” Christina Silcox, of the Duke Margolis Center for Health Policy, told The Associated Press. The center recently issued a report on the outlook for testing.

One exception will be for those enrolled in the government Medicaid program for low-income individuals and families, who will continue to receive free tests until September 2024.

"We are entering a new phase of this pandemic, and just like we did at the beginning, we will continue to learn and update our procedures to serve members of the community as best as we can," Uwazota said.

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Biden's signature of a bill ending the national emergency had no effect on the planned May 11 end to the public health emergency — a distinction easily lost on those not familiar with the nation's health bureaucracy.

"I don't think [the national declaration ending] is going to have a great effect," said UPMC infectious disease specialist Dr. John Goldman. "I think the fact that the emergency is ending is really a reflection of the fact that the virus, although it's still present, has become much less severe of a disease."

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A White House official told CNN that the ending of the national emergency did not affect the administration's ability to wind down authorities.

“Since Congress voted to terminate the national emergency earlier than anticipated, the administration has worked to expedite its wind down and provide as much notice as possible to potentially impacted individuals,” the official told CNN, adding that the country is in a “different place” than it was in January.

York County added 149 cases and one death this week to its pandemic totals, bringing them to 148,824 and 1,676 respectively, according to state Department of Health data. Eleven people were hospitalized; none were in the ICU or on ventilators.

The ending of the public health emergency will not immediately affect various telehealth flexibilities that were adopted during the pandemic. Some of those options, such as telehealth services for behavioral or mental health for Medicare patients in their homes, have been made permanent. Others, like receiving telehealth services approved in the 2023 fee schedule for Medicare patients, were extended by Congress through the end of 2024, according to the U.S. Department of Health and Human Services.

"I think what this is a reflection of is although COVID is still around, it has really made the transition from a pandemic disease, which was very severe, had spread very quickly and caused a lot of hospitalizations and death, to an endemic disease," Goldman said. "It probably will always be with us and is much less severe, causing much less death and hospitalizations."

The Associated Press contributed to this report.

— Reach Matt Enright via email at menright@yorkdispatch.com or via Twitter at @Matthew_Enright.