The federal government declared a public health emergency as the ramifications of COVID-19 first began to set in more than three years ago.
That formal declaration expires Thursday.
For many Coloradans, the sunsetting of the public health emergency won’t have a ton of tangible effects. But the end of the emergency order will leave some of Colorado’s most vulnerable even more at risk. Here’s how access to vaccines, testing and other COVID-19 measures will be affected by the emergency declaration’s expiration.
Vaccines and other treatments won’t be immediately affected, but that could change
All Coloradans, regardless of insurance status, should have some form of access to COVID-19 vaccines and boosters, even after the emergency expires.
For those under private insurance plans, Health First Colorado, and Child Health Plan Plus, vaccines will still be available at no charge. They’ll also be free for children who are “uninsured, underinsured, on Medicaid or Medicaid eligible, and/or Alaskan Native or American Indian” due to a federal child vaccination program.
For uninsured adults, local pharmacies will continue to provide free COVID-19 vaccines due to the U.S. Department of Health and Human Services’s Bridge Access Program For COVID-19 vaccines.
However, that will likely change — the federal government announced it will eventually stop buying COVID-19 shots for distribution, although an exact date hasn’t been set. When that happens, “payment, coverage, and access may change”, according to the DHHS.
Treatment for those who test positive for the virus will also continue to be cost-free, at least for now.
“Treatments such as Paxlovid will continue to be provided free as long as supplies last, independent of the public health emergency,” said Dr. Thomas Campbell, an infectious disease doctor at the UCHealth Anschutz campus. “Those will eventually be transitioned to typical coverage through insurance and third party payers.”
Free testing will likely dry up
Americans were welcomed to order free rapid COVID-19 tests through the mail several times last year, but that program will come to an end when the emergency expires.
At-home rapid tests will remain available at some state distribution sites, but those sites will eventually run out of supplies as the federal government stops paying for supplies.
A rule that mandates private insurance companies to cover eight rapid tests a month will also end, but companies are free to continue coverage. Many major providers, like UnitedHealthcare, Cigna and Aetna, said they’ll end coverage for rapid tests, unless a state government mandates them to continue. Medicaid and CHP+ will continue to cover tests through September 2024.
PCR tests, where results come back slower but more accurate, may also come at a cost. Some local public health agencies will continue to manage free community testing sites, which can be found on the Colorado Department of Health and Environment’s website.
Uninsured and underinsured people, as well as underserved communities, could be most at risk
The end of the COVID-19 public health emergency means up to 325,000 Coloradans may become ineligible or be disenrolled for the state’s Medicaid program, called Health First Colorado, or CHP+, the Child Health Plan Plus.
During the pandemic, federal laws required states to allow for continuous coverage without a standard eligibility renewal and disenrollment process.
“With the end of the public health emergency, it's really important for all Coloradans to really examine their health coverage and be aware of the options that are available,” said Adam Fox, the deputy director at Colorado Consumer Health Initiative.
Those enrolled in Health First Colorado or CHP+ will continue to have relatively easy access to vaccines, testing and other treatments. Fox said the risk primarily lies for those without insurance.
“I think for folks who are uninsured, the risk and the concern is really the diminished access to free testing and free vaccines going forward,” Fox said. “That I think will create challenges as we continue to respond to the new variants of COVID.”
Julissa Soto, an independent health equity consultant who works with the state, worries reduced access to vaccines and treatments will harm communities of color, particularly Latinos. CDPHE data models calculate that less than 50 percent of Hispanic people in Colorado have received at least one dose of the vaccine.
“The health departments are going to have the excuses of saying, ‘Well, the communities that didn’t get vaccinated can easily access a pharmacy or a federally qualified low income clinic’, which is not necessarily true,” Soto said. “We were doing bad before the pandemic, what is going to make you think that after the [public health emergency] unwinds, [this community is] going to continue with vaccines? The problem was never hesitancy, it was access.”
Soto said she hopes the state and counties will make genuine efforts to connect with undervaccinated populations after the public health emergency ends to raise vaccination rates.
COVID-19 is still causing hospitalizations and taking lives, and it’s mostly immunocompromised people at risk
According to state public health data, there are about 130 people currently hospitalized for COVID-19. Deaths are extremely low compared to pre-vaccine dates and major waves.
Campbell said most, if not all, of the people he’s seen hospitalized by COVID-19 are severely immunocompromised.
“People who are most vulnerable, people who are immunosuppressed and may not have good immune responses to vaccination or [the] small percentage of people who have not been vaccinated yet, or not recovered from natural infection, those individuals still remain vulnerable to getting severe illness that might result in hospitalization or death, and they need to be particularly vigilant,” he said.
There are several ways people can continue to stay safe from COVID-19. Campbell said the most important way is to stay updated on vaccines and boosters. Federal health officials now recommend that everyone receive an updated bivalent booster, which protects against new variants that didn’t exist when first vaccines were introduced. Adults 65 years and older may also get a second shot of the bivalent booster and an updated vaccine is expected to become available for the general public sometime in the future.
And, while mask mandates have been long gone, Campbell said masking still significantly reduces risk of contracting COVID-19.
“I certainly do encourage people who have illnesses or age that puts them at high risk to continue to wear a mask in public places,” he said.
More than 15,000 Coloradans have died due to COVID-19. Colorado has seen about 1.8 million cases since the pandemic first began, according to the state health department.
CPR News' John Daley contributed to this story.
