The federal COVID emergency is ending, but Californians get 6 extra months of free tests

The Golden State's guaranteed coverage of COVID tests and reimbursements from insurance providers kicks in when the federal COVID emergency ends Thursday.

If your medicine cabinet is low on COVID tests, you only have a few days left to stock up for free from the federal government.

And starting Friday, the feds also will no longer protect patients from being billed for their COVID testing.

But there’s good news for Californians: The state legislature has given Golden State residents an extra six months of guaranteed coverage of COVID tests and reimbursements from their insurance.

Changes are coming next week in much of the country as the federal government’s COVID national and public health emergencies end on May 11, more than three years after they were declared by then-President Trump and the Department of Health & Human Services as the virus was first detected in the United States.

California’s state public health emergency ended Feb. 28, and on Friday the World Health Organization declared the end to the COVID-19 global emergency. The WHO announcement, along with the end of the U.S. and California emergencies, marks an important moment in the devastating pandemic that triggered once-unthinkable lockdowns, upended economies and killed millions of people worldwide.

“It’s with great hope that I declare COVID-19 over as a global health emergency,” WHO Director-General Tedros Adhanom Ghebreyesus said. But, he added, “That does not mean COVID-19 is over as a global health threat,” warning that new variants could yet emerge.

Unlike the end of the global emergency, which is largely symbolic, the passing of the federal and state emergencies take with them many programs and protections that affect you.

“We’ve basically gone from a system where there’s been universal coverage of COVID vaccines, testing and treatments,” said Jen Kates, senior vice president at KFF, a nonprofit focused on health policy. “Now we’re going back to the regular system, which for tests and treatments means cost-sharing,” and protections vary widely based on your state and type of insurance.

While California is extending free COVID testing six months for all insured people, the 15.4 million Californians who are covered by Medi-Cal, the state’s health insurance program for low-income residents, will have the benefit for even longer: Free COVID tests or reimbursements will be available to them until September 2024.

But another recent change could threaten benefits for some current Medi-Cal recipients. For the first time since the COVID emergencies began, the federal government is requiring states to verify every enrollee’s eligibility. Over the next 14 months, “millions of Medi-Cal beneficiaries may lose their coverage” if they don’t take action to re-enroll, according the state’s Department of Health Care Services.

Unwinding the various patient protections around COVID testing and treatment is going to be complicated, Kates said.

For example, the federal government still has reserves of oral antiviral medications used to treat COVID, including Paxlovid, which will continue to be free to patients and providers until those doses run out. At that point, pharmaceutical companies, insurance companies and health care providers will take over the supply and costs.

After California’s rules requiring free tests expires, health care providers and local public health systems could still choose to provide free tests, but there are no longer any guarantees.

“In compliance with California law, COVID-19 vaccines, home antigen and PCR testing, and treatment will continue to be provided and covered at no cost for the next 6 months,” Kaiser Permanente said in an emailed statement. But the insurer did not provide details on what would happen after Nov. 11.

Moving forward, people will be able to use their pre-tax health-care flexible spending accounts to pay for their share of COVID-prevention costs. According to the Internal Revenue Service, “the costs of personal protective equipment, such as masks, hand sanitizer and sanitizing wipes, for the primary purpose of preventing the spread of COVID-19 are eligible medical expenses” and can be paid or reimbursed from flexible and health savings accounts.

Otherwise, most people won’t notice the end of the COVID emergencies in their everyday lives. Mask mandates and vaccine card checks are already a thing of the past. But hospitals, insurance companies, and health care administrators are preparing for some big changes in when, how and for whom COVID care is subsidized or covered by insurance.

COVID vaccines, which should still be free in most cases, will be paid for by insurance providers, public and private, instead of just the federal government. According to a report from Kates and her colleagues, Pfizer and Moderna are likely to raise the cost of their vaccines by a factor of three or four, and they estimate the change could cost providers $14-$17 billion annually, even if just half of U.S. adults gets vaccinated each year.

There are some other changes that could hit people in their pocketbooks, including the end of some COVID-era supplemental food assistance.

While the pandemic led to a boom in tele-health and online medical appointments, the once-loosened rules governing those interactions are being rolled back, including the ability to prescribe controlled substances during tele-health appointments.

For health policy nerds such as Kates, there is a lot more that is worth noting about the end of the public emergencies. For example, laboratories and local public health departments will no longer be required to report COVID test results to the Centers for Disease Control and Prevention. And the CDC announced on Friday that it no longer would publish data on community transmission that was widely used to track risks and set policy.

“It will be a loss of visibility into what is happening,” Kates said.

The Associated Press contributed to this report.

How to order free COVID tests

Go to www.covid.gov/tests to order free at-home COVID-19 rapid tests from the federal government through Thursday. They will be delivered by mail to households that have yet to reach the limit of 4 free tests.