A health care worker preps a COVID-19 test for a child at a testing site on 24th and Mission streets in San Francisco on Nov. 30, 2020. (Beth LaBerge/KQED)
The end of the federal public health emergency will have big impacts on how people in the United States access COVID care, and how much they’ll pay for it. But a lot of these changes won’t actually apply to Californians — at least not for folks with health insurance.
Keep reading for what you need to know about how your access to COVID vaccines, bivalent boosters, free tests and treatments like Paxlovid has changed — or hasn’t changed — since May 11.
I thought the state of emergency had already ended?
You’re not wrong. There have just been several states of emergency for COVID, on the local, national and international levels.
On Feb. 28, California ended its own COVID state of emergency. This move was characterized as “a symbolic end” to the pandemic in the state, and a “decision [that] will have little practical impact on most people’s lives.” When the state announced the order would be lifted in February, the majority of the 600 pandemic-related orders Newsom had issued since March 2020 had been lifted. Many cities around California still had their own states of emergency, and have lifted those since.
On April 10, the federal national emergency ended early. This emergency order, which was separate from the federal public health emergency that’s ending this week, was originally set to also expire on May 11 — but a bipartisan congressional resolution moved to bring this order to a close ahead of schedule.
It’s true that the end of these national emergencies will have big effects on nationwide funding for COVID vaccines and testing. This means that in other states, people with health insurance will find that their insurers no longer have to cover the costs of COVID care like testing and treatment.
But California has enacted several laws that force insurers to keep covering COVID care even after the state and federal states of emergency end (more on this below).
COVID vaccines will most likely remain free for people with insurance for all of the United States
The White House’s COVID-19 Response Coordinator Dr. Ashish K. Jha promised that COVID vaccines will remain free in the U.S. for insured people as a preventive service covered under the Affordable Care Act of 2010.
In California, Senate Bill 510 requires insurers in California to keep covering COVID costs like testing and vaccination after the national public health emergency ends anyway.
People in California with health insurance can still get Paxlovid for free
Another California law — SB 1473 — requires insurers to keep covering the costs of COVID therapeutic treatments like Paxlovid. This also applies to people on Medi-Cal and Medicare. This law only keeps the current situation in place until six months after the end of the federal public health emergency, on Nov. 11.
People in California with health insurance can still get reimbursed for COVID tests
SB 1473 also requires insurers to keep reimbursing their members for the costs of up to eight over-the-counter COVID tests a month. This also applies to people on Medi-Cal, but again, this law is only in effect until Nov. 11.
If you see signs in your local pharmacy saying that May 11 was your last chance to get the cost of your COVID tests reimbursed by your insurer, remember: If you live in California, this isn’t accurate.
What happens after Nov. 11? If you want Paxlovid or to get reimbursed for COVID tests by an insurer after that date, you’ll have to make sure you are obtaining these services “in network.” Right now, specific details about what that will look like in practice come November are still lacking.
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After May 11, how can people in California without health insurance access COVID care?
Thanks to state legislation from 2020, California has offered uninsured state residents free COVID testing, hospital care and treatment via Medi-Cal providers during the pandemic — if they signed up for the state’s COVID-19 Uninsured Group program, managed by the Department of Health Care Services. But this program is ending on May 31, 2023.
The state’s materials for uninsured people state that Covered California has a special enrollment period “due to the COVID-19 Public Health Emergency.” This special enrollment period “will end 60 days after the last day of the month when the Public Health Emergency ends” — which is July 30.
To enroll by the end of this special pandemic enrollment period, the state suggests to visit coveredca.com/apply and choose “Pandemic (COVID-19)/Public Health Emergency” as your qualifying life event from the “Special Enrollment” drop-down menu. The date of your qualifying life event should be the current date. You can also enroll in Covered California if you have another qualifying life event.
Accessing COVID vaccines in California when you’re uninsured
The California Department of Public Health (CDPH) told KQED in an email that “for the uninsured, free COVID-19 vaccines and pill medications at most pharmacies, public health clinics, and federally-supported clinics will continue for now.”
Finding COVID tests in California when you’re uninsured
The White House website covid.gov/tests has been offering separate orders of free COVID antigen tests for each household during the pandemic. This program looks to be continuing after the federal public health emergency ended on May 11, but it’s unclear how much longer it’ll last.
So tell us: What do you need to know more about? Tell us, and you could see your question answered online or on social media. What you submit will make our reporting stronger, and help us decide what to cover here on our site, and on KQED Public Radio, too.
This story has been updated to reflect that Medicare no longer covers the cost of over-the-counter COVID tests, only PCR tests ordered by a health care provider for Medicare Part B users.
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