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On May 11th, 2023, the Biden administration will end the national emergency and public health emergency (PHE) related to COVID-19. The COVID-19 pandemic is not over. Ending the public health emergency will harm many people. Over a million people have died. The number of COVID cases are at record highs, and over 3,000 people in the United States are still dying of COVID every week. Less than 20% of the US has the bivalent booster. This is especially true for marginalized people. For all of these reasons, COVID is continuing to harm our communities. Ending the public health emergency gives the dangerous impression that the COVID-19 pandemic is over. People need to continue to think about risk and community transmission. People need to continue to mask, people need to ensure that they are up to date with all boosters. People with developmental disabilities are especially vulnerable to COVID-19. Many in our community have additional risk factors, like heart or lung issues. COVID-19 is especially dangerous in congregate settings such as nursing homes, and it will continue to spread. COVID-19 was the leading cause of death for people with intellectual and developmental disabilities (I/DD) in 2020. People with disabilities, low income people, and people of color are more likely to have bad outcomes from COVID-19, including death. Ending the PHE will negatively impact health care and health care coverage, especially for marginalized people who had difficulty accessing care even before the pandemic. During the public health emergency, Medicaid coverage has been more open and flexible than usual in many states. Medicaid has had enhanced federal funding. States could also not take people off of Medicaid. Over 19 million people enrolled in Medicaid since February 2020, whether due to this expansion or people who newly qualified due to changes in disability status, financial status, or age. On April 1, states will be able to reduce coverage and will no longer have the enhanced federal funding for Medicaid. Millions of people will no longer qualify and lose Medicaid coverage. Even more will lose coverage even though they still qualify, because the requirements to keep this coverage will be more demanding. The groups who will lose the most coverage despite qualifying will disproportionately be children and people of color. This is expected to be the biggest increase in uninsured children in the history of the United States. Hospitals that relied on pandemic-response higher reimbursement rates for Medicare and flexible waivers and eligibility requirements for certain classes of health care will no longer receive these payments. This will result in decreased access to care. Ending these reimbursements will leave hospitals worse-equipped to handle future Covid cases. This is especially bad because COVID-19 is a mass disabling event. Health systems serving hard-hit communities will struggle to meet the additional medical need COVID has brought about. This will mean that many people who need health care because they became disabled from COVID will not have access to it. Cost sharing provisions for COVID-19 tests for people on private insurance, Medicaid, and Medicare are ending. People on these plans will have to pay more for COVID tests. Tests will become less available as a result, leading to more spread and less-accurate information about COVID risk in communities. Uninsured people used to be covered for COVID-19 tests, treatments, and vaccines, but without additional federal funding for these programs, people without insurance have been left vulnerable since last spring. Ending the public health emergency also means there will be fewer tools to help people make informed decisions about COVID. States will stop having to report COVID-19 data to the government. ASAN had to end our COVID-19 case tracker for congregate settings in January of this year due to lack of data. This lack of information will make it hard for people to find out how much COVID is circulating in their communities. It also makes it more difficult to see the impact specifically on marginalized communities. The public health emergency status provided care to many people who need care to survive the pandemic. Ending it harms our communities. COVID-19 is not over. Autistic Self Advocacy Network PO Box 66122
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