COVID-19 public health emergency declarations end soon. What will change?

It’s typical of our three-year COVID-19 odyssey that there’s no perfect ending.

In two months, pandemic public health emergency declarations will expire -- a move that comes with cases and hospitalizations at manageable levels and tools in place, including vaccines, to fight COVID-19.

But pulling the plug on federal and state public health emergencies, which enabled actions such as setting up mass vaccination sites, is not without repercussions. They include thousands losing Medicaid, no more at-home COVID-19 test reimbursements for many, and general confusion.

“People have lots of questions,” Cook County Health chief medical officer Claudia Fegan said.

Here’s a look at some of the changes expected when state and federal public health emergencies end.

Medicaid quandary

As the deadly virus spiraled, the federal government increased Medicaid funding to states and stopped requiring participants to re-register every year.

The continuous enrollment program ends March 31, meaning Medicaid users must renew or risk being uninsured. In Illinois, the first notices go out in May for people with coverage due for renewal in June.

But for Medicaid participants who moved, “there is significant concern that people will lose coverage because they didn’t get the mail,” said Kara Murphy, president of the DuPage Health Coalition, which helps low-income residents find health care.

“The other issue is there are people who won’t qualify for Medicaid ... even if they get the mail.”

Examples are teenagers who turned 19 during the pandemic. Children typically age out of family Medicaid coverage when they turn 19, meaning they must apply and meet eligibility requirements based on income.

Federal data indicates up to 700,000 statewide could fall off Medicaid, but the Illinois Department of Healthcare and Family Services estimates it’s closer to 384,000.

“The truth is, nobody knows for sure,” department spokeswoman Jamie Munks said. “What we do know is that we are committed to ensuring everyone who is eligible maintains their coverage, and that those who are deemed ineligible are given information about finding alternative coverage.”

The agency has a Ready to Renew tool kit in multiple languages, and groups like the DuPage Health Coalition are helping clients such as Brigida Lopez-Flores of Glendale Heights enroll.

Medicaid is crucial, Lopez-Flores said at the coalition’s site in Carol Stream Thursday. “We don’t have that many resources. We want something to help us when we go to the hospital. Like having annual physical exams that are covered.”

COVID-19 tests

Emergency or not, a nose swab will always feel weird.

But one major shift with over-the-counter tests is that private insurance companies will no longer have to offer reimbursements, although some may opt to continue.

For example, after May 11, Blue Cross and Blue Shield of Illinois has decided “over-the-counter COVID-19 diagnostic tests will not be covered through medical or pharmacy benefits,” senior communications manager Dave Van de Walle said.

Before that happens, Northwestern Lake Forest Hospital Medical Director Michael Bauer has some advice: “Take advantage of being able to go get free tests and stock up.”

It’s also a good idea to check with your health care provider since plans vary. Medicaid is expected to keep free tests through September 2024, the Kaiser Family Foundation said.

Vaccines

In general, officials expect COVID-19 vaccines will continue to be easily available, although there are some unknowns about funding given that the U.S. government’s stockpile won’t last forever.

“The ending of the public health emergency will not immediately impact vaccine access,” Illinois Department of Public Health spokesman Michael Claffey said. “The commercialization of the vaccines may have an impact, but that is likely to occur a few months down the line.

“We are awaiting details for how Medicaid, Medicare and private insurances will cover COVID-19 vaccines, and we are also awaiting guidance on programs for uninsured or underinsured adult patients.”

Meanwhile, pharmaceutical giant Moderna Inc. pledged in February it would provide COVID-19 vaccines at no cost to Americans.

Will there be an annual updated COVID-19 booster shot in autumn as we have with flu?

COVID-19 is not a seasonal disease like flu, Bauer said. “It’s still endemic, meaning -- it’s just there,” but the vaccine can be tweaked fairly quickly to respond to virus mutations, he noted.

He thinks it’s likely the CDC will issue recommendations for a yearly booster.

Health experts also urge people to get vaccinated. “People are still getting COVID,” Fegan said. “We still have illness and deaths.”

Food stamps

Additional fallout is expected when an extra SNAP payment to help needy families buy groceries ends this month. The supplement added during the pandemic averaged $90 per household member.

It comes when local food pantries are reporting higher demand as inflation increases food costs.

The Northern Illinois Food Bank is now helping feed about 450,000 people per month, 55% more than before the pandemic, said Maeven Sipes, the organization’s chief philanthropy officer.

Janet Derrick, the executive director of Naperville-based food pantry Loaves & Fishes, said earlier this month her organization served more than 2,000 households in a single week, the most in the pantry’s history.

“We’re seeing some people we haven’t seen since 2020,” Derrick said.

Sipes said the second payment going away might mean increased traffic at local food pantries as people run low on SNAP funds near the end of March.

“Feel free to use the pantry sooner in the month,” Sipes said. “Don’t wait until you’re out of SNAP money to come to the pantry.”

Volunteers and donations also are needed, she said. “We definitely need the support now more than ever.”

Telehealth

The public health emergencies broadened the use of virtual doctor visits during the pandemic, and experts said telehealth won’t go away when they end.

“But I’m a strong believer at some point you have to look at the patient -- you have to physically examine them,” Cook County Health’s Fegan said. “We have patients that have been reticent to come back, and we’re encouraging them to come back.”

However, one change in pandemic rules allowing providers to write prescriptions for controlled substances without seeing patients in person will stop after May 11, the Kaiser Family Foundation reported.

Masks and data

The state relaxed rules requiring masks at health care facilities in October 2022, although numerous entities kept them in place.

Going forward, fewer masks in hospital lobbies are expected, but face coverings will likely predominate in doctor’s offices.

For example, Northshore -- Edward-Elmhurst Health announced March 13 it would require masking in clinical settings and common areas where there are patients and visitors but not in nonclinical areas.

Fegan expects “in that patient-provider exchange there still will be a requirement for mask-wearing because we’re vulnerable, right? We’re trying to keep our workforce safe.”

After months of daily updates, the IDPH scaled back COVID-19 data reporting on its website to weekly tallies of cases on Jan. 1.

Currently, “regarding data reporting, we are not ready to announce any change now,” Claffey said.

Wastewater monitoring for virus trends will also continue.

• Daily Herald staff writers Doug T. Graham and Paul Valade contributed to this report.

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