Even if pandemic lull lasts, more health care challenges are coming

cdcmarch22covidhospitalization-300x174The coronavirus pandemic does not have a magical on-off switch, and even if its current lull turns out to be longer lasting — and signs suggest this may not be so — the lethal infectious outbreak will keep sending shocks through the U.S. health care system that will affect us all.

Experts are expressing growing concern about several areas where patients, insurers, and medical providers must make major, challenging changes if federal officials truly see huge reductions in the pandemic’s threat and they begin to wind down key programs put in place to battle it, the Associated Press reported.

If that occurs, health insurance for millions of Americans could change swiftly and dramatically, while many patients and health providers may be forced to reconsider the future of telehealth care, the AP reported. And how much support will there be for continued efforts to test, vaccinate, and provide treatments for the coronavirus, if the pandemic diminishes as a major peril?

The tremors in health coverage may hit early and hard, the news service reported:

“Medicaid, the state-federal health insurance program for low-income people, is covering about 79 million people, a record partly due to the pandemic. But the nonpartisan Urban Institute think tank estimates that about 15 million people could lose Medicaid when the public health emergency ends, at a rate of at least 1 million per month. Congress increased federal Medicaid payments to states because of Covid-19, but it also required states to keep people on the rolls during the health emergency. In normal times states routinely disenroll Medicaid recipients whose incomes rise beyond certain levels, or for other life changes affecting eligibility.

“That process will switch on again when the emergency ends, and some states are eager to move forward. Virtually all of those losing Medicaid are expected to be eligible for some other source of coverage, either through employers, the Affordable Care Act or — for kids — the Children’s Health Insurance Program. But that’s not going to happen automatically, said Matthew Buettgens, lead researcher on the Urban Institute study. Cost and lack of awareness about options could get in the way. People dropped from Medicaid may not realize they can pick up taxpayer-subsidized ACA coverage. Medicaid is usually free, so people offered workplace insurance could find the premiums too high. ‘This is an unprecedented situation,’ said Buettgens. ‘The uncertainty is real.’”

Biden Administration officials already have started working with states to try to make coverage transitions easy and effective. But explaining coverage and its options has never been a snap.

And the issue of federal involvement in health care is as politically divisive as ever, with Republicans zealously opposed to it, notably in their decade-plus campaign against the Affordable Care Act, aka Obamacare, and especially that programs expansion of Medicaid. A dozen states, most in the South and politically red, never expanded Medicaid and this further complicates messaging about what recipients nationwide may need to do as pandemic support for health coverage fades.

Obamacare subsidies expiring and midterms loom

The issue may loom even larger as the midterm elections near. That’s because pandemic aid also supported a temporary expansion of health coverage available to millions on ACA exchanges. Record numbers of Americans, including the working poor, middle class, and “gig” workers now have health coverage under Obamacare.

But stubborn Republicans, abetted by a few outlier Democrats, have blocked President Biden’s Build Back Better plan, which included additional and sustained funding for the latest fixed and expanded Obamacare.

Voters may find brutal political battling breaks out yet again over health insurance, whether over the expanded ACA subsidies or ensuring Medicaid covers as many of the poor, working poor, and the chronically sick and mentally ill.

As for telehealth or remote treatment options, these, too, got a temporary green light during the pandemic, and experts still are evaluating their benefit, as well as whether to continue to allow them. They have won converts among patients as well as medical providers. But laws and regulations must change if this caregiving approach will stick around in the wider fashion that occurred during the pandemic.

GOP balks at funds to keep fighting pandemic

Public health officials insist that research and experience have shown certain ways can be vital to knock down the coronavirus and keep it from mutating and threatening the planet as it has in its original, Delta, and Omicron variant surges. But will lawmakers on Capitol Hill fund sustained programs to vaccinate against, as well as to test and treat for the coronavirus?

GOP lawmakers have balked at the administration’s funding requests, with the arguing over the requested sums becoming contentious enough that Democrats pulled them from a giant budget package that will keep the federal government running for several more months.

Republicans say Congress already has provided more than enough pandemic aid, the country is awash with it, and they, suddenly, have insisted on detailed accounting from the administration of already appropriated sums. Democrats thought they had struck a compromise with their GOP colleagues, who demanded that Washington claw back pandemic funding promised to the state to pay for continuing public health efforts to battle the coronavirus. Governors had protested this plan.

GOP lawmakers, according to news reports, have slashed the further pandemic funding they have told the Democrats and administration they will support, notably by eliminating billions of dollars this country had said it would provide to help poor nations around the globe increase their access to safe, remarkably effective coronavirus vaccines. The president and his experts have insisted this may be penny wise but certainly is pound foolish because it all but invites the possibility of the virus taking hold of a poor, vulnerable population elsewhere and mutating, potentially with a new, more contagious and virulent variant emerging and spreading.

Keeping up the fight against the pandemic is getting harder, as hospitals are reporting they are treating new low numbers of coronavirus patients needing institutional care. Cases keep dropping, as are deaths. Public health experts are watching the pandemic metrics with wariness, both because the newer and more contagious BA.2 variant is becoming predominant and declines in cases, hospitalizations, and deaths seem to be hitting a new, albeit lower plateau, as compared to the off-the-charts numbers experts say during the Delta and Omicron surges.

Let’s not forget, too, that the coronavirus has killed at least 1 million Americans, infected almost 80 million of us,  left hundreds of thousands of children without parents, and untold millions suffering debilitating medium and long Covid.

We are not done with pandemic and we all would be wise to recognize this, including sustaining the money to battle the disease. Regular folks appear to be having varied reactions to health officials easing coronavirus measures. But those with heightened vulnerability to the virus — those who are older, immunocompromised, overweight, and with underlying conditions, or individuals from hard-hit communities of color — still may be staying careful, including by keeping on their masks. Those using public transportation also must keep their masks on for a while longer.

A word to the wise: Don’t toss out your masks yet. Maybe you’ll want to build up your supply, nabbing test kits, too (free from the federal government, including a second round of them, and delivered to your door). Just in case.

The vaccines remain life changers and life savers. If you have not gotten your shots, please do so, boosters and all, pronto. If you haven’t chatted with your doctor for a bit, you should — especially about whether your individual health would benefit from an additional dose of vaccine and when might be the time to get it. If you have been exposed or think you have gotten infected, please get tested — and quarantine or isolate to protect yourself and others.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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