For journalists seeking important health care policy stories in 2023, look to the impact of the end of the public health emergency on Medicaid enrollment and how it may change the number of people who are uninsured, experts said on March 11 during “Public health legislation in the new Congress” session at Health Journalism 2023 in St. Louis. Federal action on telehealth and its impact on health equity and rural health care will also be key policy topics to follow during the year, they said.
The federal COVID-19 public health emergency declared as the pandemic began in 2020, is now set to expire this year on May 11, which will have huge consequences on eligibility for Medicaid, the joint federal and state health insurance program for low-income adults, pregnant people, children, and people with disabilities.
“How many people will actually lose their Medicaid coverage” because of the ending of the public health emergency, said Timothy McBride, a Washington University professor of public health, during a panel titled ‘Public health legislation in the new Congress’.
“We’re watching that like a hawk … and I recommend journalists do that too.”
McBride was joined on the panel by Cara Tenenbaum, principal at D.C.-based Strathmore Health Strategyand Leann Chilton, vice president of government relations at BJC Healthcare, a St. Louis-based health provider.
During the pandemic, state Medicaid programs received extra funds from the federal government as an incentive to keep low-income adults and children and those with disabilities enrolled automatically in Medicaid. As part of the planed health emergency expiration, states can begin, on April 1, restarting the process of requiring beneficiaries to certify their income status and eligibility for Medicaid coverage.
The process of disenrolling people will take many months, but it is likely to result in as many as 18 million people losing their Medicaid coverage and their reduced access to health services, according to the Urban Institute.
In Missouri, for example, Medicaid enrollment rose 600,000 during the pandemic, and McBride expects hundreds of thousands to lose coverage in the coming months. Journalists, he said, should be chronicling the impact of the loss of this insurance on communities.
“This is going to be a really important issue to providers, hospitals and to everybody,” he said.
The removal of people from Medicaid will likely impact the uninsured rate which declined to 10.2%by the end of 2021, compared with 10.8%in 2019, according to the Kaiser Family Foundation.
In the coming year, federal lawmakers are also likely to be discussing how to make permanent and certain temporary changes in telehealth regulations that were implemented as part of the public health emergency.
During the pandemic, lawmakers lifted many restrictions on health providers’ ability to offer and be paid for care through Zoom and other video communication technologies in patients’ homes, nursing facilities and emergency rooms. The lifting of rules on telehealth was particularly helpful in rural communities where there are fewer health care providers for people to see and helped to close health equity gaps.
Congress passed legislation at the end of 2022 that extended many of the telehealth regulations until 2024, but they are still scheduled to sunset in two years. Chilton said these are policies that many health providers would like to become permanent.
“I hope that one of the lessons learned from the pandemic is the promise of telehealth,” she said.