What the end of the COVID-19 national emergency means

The Senate passed a GOP-led resolution Wednesday night to end the COVID-19 national emergency, and President Biden has riled Democrats with his plans to sign it. 

Experts say the end of the emergency will have a “limited impact,” despite the White House warning earlier this year it “would create wide-ranging chaos and uncertainty throughout the health care system.” 

The resolution will end a number of waivers for federal health programs Medicare, Medicaid and CHIP, however many of the changes to healthcare regulations have become largely irrelevant as COVID-19 precautions have been relaxed.

The Biden administration had already set an impending deadline for both the national emergency and the public health emergency to end. In January, a May 11 deadline was announced, giving states the go-ahead to begin winding down the measures enacted under the emergencies.

The COVID emergency also provided the power for former President Trump and later Biden to pause student loan repayments. However, Biden’s student loan forgiveness plan is now being challenged at the Supreme Court, and student loan repayments are set to begin either 60 days after the Supreme Court ruling or 60 days after June 30.

“The ending of the national emergency declaration, should the President sign the resolution passed by the Senate, would have a limited impact,” Jen Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation, said in a statement to The Hill.

Trump declared a national emergency concerning COVID-19 in March 2020, granting the Health and Human Services (HHS) secretary emergency authority to “temporarily waive or modify certain requirements of the Medicare, Medicaid, and State Children’s Health Insurance programs” over the course of the emergency declaration.

Under the national emergency, HHS issued blanket waivers for federal conditions including certain requirements for Medicare provider enrollment; requirements for in-person meetings between providers and patients; as well as requiring out-of-state Medicare and Medicaid providers to be licensed in the state where they are providing services.

States and territories were also allowed to request additional, time-limited, flexibilities for their Medicaid and CHIP programs. Providers were given the flexibility to administer services in “alternative settings” like unlicensed facilities and temporarily enrolled providers were allowed to forgo requirements like paying application fees or undergoing criminal background checks.

As these waivers were issued at the start of the pandemic, around the same time when lockdowns were being ordered, many of the rules were loosened to reduce the number of people leaving their homes for medical services, expand the capacity of critical care hospitals and ensure that patients could still receive care.

“There are only a limited number of flexibilities tied to the national emergency declaration, such as waivers of some state Medicaid provider requirements,” Kates said. “It is also likely that states using such flexibilities have already ended them or are preparing to do so given the May 11 date. The bottom line is that the public is unlikely to experience any noticeable changes due to the ending of this declaration a month before the PHE.”

Still, Biden signing the legislation marks a stark reversal for the president. Almost 200 House Democrats had voted on Feb. 1 against the Republican proposal for an immediate repeal of the emergency designation after the White House sounded its warning about the resolution.

The president’s shift was particularly galling for the party’s frontliners facing tough reelection contests next year. 

“It’s frustrating,” said Rep. Dan Kildee (D-Mich.). “At best it’s [an] unacceptable lack of clarity in their message to us.”

“I find it surprising and I’d like to see a little more consistency,” said Rep. Lloyd Doggett (D-Texas).