High angle view of young woman painting with roller on red COVID-19 virus over white background
(Credit: Klaus Vedfelt / Getty Images)

Twenty-five Republican governors have signed a letter asking President Joe Biden to end the COVID-19 public health emergency, saying “it is time we move on from the pandemic and get back to life as normal.”

“While the virus will be with us for some time, the emergency phase of the pandemic is behind us,” reads the letter, which carries Monday’s date. “We have come so far since the beginning of the pandemic — we now have the tools and information necessary to help protect our communities from COVID-19.”

Acting under the assumption that the federal PHE, set to expire Jan. 11, will be renewed at least until mid-April, the coalition of governors asked that the PHE be allowed to expire in April. The governors also asked for notification “well in advance” of its expiration.

“The industry is facing the triple threat of COVID, flu and RSV this winter,” Jeanne McGlynn Delgado, American Seniors Housing Association vice president of government affairs, told McKnight’s Senior Living.

The federal government, she said, should “carefully monitor the resource and policy needs of the industry relative to the PHE over the next several months” before making decisions about ending it.

Particular focus, Delgado said, should be given to telehealth, which has proven more efficient and timelier; staff training waivers, which added to the workforce and can benefit the industry long term; and potential Public Readiness and Emergency Preparedness (PREP) Act protections. 

A spokeswoman for the American Health Care Association / National Center for Assisted Living told McKnight’s Senior Living that it’s “critical” for the PHE to continue to allow for “flexibilities necessary to respond to the ongoing pandemic, address challenges exacerbated by it and protect access to care for our nation’s most vulnerable.”

Last month, in a letter to US Department of Health and Human Services Secretary Xavier Becerra, ACHA/NCAL called for an extension of the PHE.

The governors, in their request, said that the PHE negatively affects states by artificially increasing the number of people covered under Medicaid. Since the beginning of the pandemic, states have added 20 million people to Medicaid rolls, a 30% increase, they said. 

“While the enhanced federal match provides some assistance to blunt the increasing costs due to higher enrollment numbers in our Medicaid programs, states are required to increase our non-federal match to adequately cover all enrolled and cannot disenroll members from the program unless they do so voluntarily,” they wrote. “This is costing states hundreds of millions of dollars.”

That argument could be moot, however, if a proposed $1.7 trillion spending package is passed this week. Passage of the package would restart Medicaid redeterminations, paused during the PHE, in April, regardless of the status of the public health emergency.

The Robert Wood Johnson Foundation reported that as many as 18 million Medicaid enrollees could lose their health insurance once the PHE expires. 

Extended 11 times

The PHE related to COVID-19 has been extended 11 times since it began Jan. 31, 2020. Previous HHS Secretary Alex Azar initiated it and then renewed it three times in 2020 — on April 21, July 23 and Oct. 2 — as well as on Jan. 7, 2021. Becerra previously renewed it three times in 2021 — on April 15, July 19 and Oct. 15, 2021 — and four times in 2022 — on Jan. 14, April 12, July 15 and Oct. 13.

The federal government previously vowed to provide a 60-day notice of when it planned to end the PHE, but no notification came last month, and published reports cited confirmation from Biden administration officials that the PHE will not end in January.

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