Experts warn of costlier COVID care as emergency declaration ends

Most Americans can expect to pay more for COVID-related care when the federal government ends its pandemic emergency declaration Thursday.

That's the warning from health care experts who say free access to tests, treatments and vaccines is coming to an end for many Americans when the federal emergency ceases and insurance carriers begin playing a larger role in COVID care options.

“The problem is we've been relying on testing, treatments and vaccines being widely available as a public health measure, and those tools were paid for by the emergency declaration,” said Dr. Emily Landon, head of the University of Chicago's infectious disease prevention and control program. “The last people who should be making decisions about public health is the insurance industry. We don't want to see these tools become inaccessible.”

Illinois Department of Public Health Director Dr. Sameer Vohra said he hopes for a “minimal transition as people get back to the traditional system from which they get care.”

While most free COVID-19 related initiatives are still available to those with Medicaid, the pool of eligible recipients decreases significantly with the end of the emergency declaration. Somewhere between 400,000 and 700,000 in Illinois alone could lose coverage after Thursday.

“I'm really concerned for those folks without insurance,” said Dr. LaMar Hasbrouck, head of the Cook County Department of Public Health, which services the suburban portion of the county. “They're the ones who could be most affected by the cost of future COVID care.”

The biggest unknown is cost, health care experts said.

“We're going back to the status quo where what kind of insurance you have determines how much you pay out of pocket,” said Caitlin Donovan, senior director at the Virginia-based Patient Advocate Foundation, a nonprofit group providing case management services and financial aid to the chronically ill. “That's not good because it means those costs are going to be shifted as much as they can onto patients.”

Insurance carriers have already notified clients they will no longer reimburse purchases of at-home COVID tests once the federal emergency declaration ends.

“It's clear Congress isn't going to pass anything to make these tools widely accessible and limit costs,” Landon said. “That's going to be a problem. I just don't know how big of a problem that's going to be.”

Donovan's group maintains an online database of financial assistance available throughout the country at its website, patientadvocate.org.

Health care experts also are unsure what will happen with virtual doctor visits.

Telehealth usage exploded during the pandemic, allowing patients to visit with doctors by phone or screen to access all kinds of health care needs, not just COVID-related issues.

“Again, it's unknown if insurance companies are going to require in-person visits for COVID treatments like Paxlovid,” Landon lamented. “We are at their whim.”

Meanwhile, the immediate threat from COVID-19 is trending downward.

The end of the federal government's emergency declaration comes as the World Health Organization declared an end to COVID-19 being a “global health emergency” Friday.

Locally, IDPH officials Friday reported only five deaths from the virus over the past week. That's the lowest weekly total of the pandemic.

“We're very happy to report some of these really positive signs, but the virus is still circulating and we know it will go in different types of waves,” Vohra said.

Hospitalizations from the virus are also at some of the lowest levels of the pandemic. Statewide, hospitals Thursday were reporting 404 COVID-19 patients being treated, 46 of whom were in ICU beds.

At its worst, there were days when more than 7,000 COVID-19 patients were being treated in Illinois hospitals and nearly 1,200 of them were in intensive care, records show.

Hospitals will stop reporting daily COVID-19 patient figures this week, IDPH officials announced Friday.

“We will still have the ability to know through our surveillance methods when those hospitals and other places are being burdened,” Vohra added.

Public health officials also noted they are not letting their guards down and will continue to use many of the monitoring practices that have been in place throughout the pandemic.

“The game-changer will be any new variant or subvariant that can happen at any time and starts ripping through the community,” Hasbrouck said. “The good news is, we have the muscle memory, so to speak, to be able to ramp up our efforts to combat any surge that might happen if necessary.”