Could the COVID emergency's end affect vaccines, tests, treatment? Here's what we know

COVID-19 vaccines will remain free for all at least temporarily after local, state and federal emergency orders end but people will have to pay more for home tests starting in May and many may eventually face charges for medications like Paxlovid.

On Tuesday, the Ventura County Board of Supervisors voted to end the nearly 3-year-old local COVID emergency order on Feb. 28, the same day California’s statewide emergency ends. The federal declarations conclude about two months later on May 11.

Nearly all mandates and restrictions in Ventura County were long ago removed. The local order was used mostly to facilitate federal reimbursement of pandemic aid programs. Officials said few if any disturbances to vaccines, testing and medications are expected after the order's end in about two weeks.

But the May expiration of the federal order will mark the beginning of a transition to insurance coverage, which determines how much people pay for COVID-19 tests and eventually vaccines and medications like Paxlovid.

“Those who are uninsured and under-insured will lose out. That is a common thread,” said Jen Kates,  a senior vice president at the Kaiser Family Foundation nonprofit that analyzes national and global health issues.

Officials for the U.S. Department of Health & Human Services said on Thursday access to care will be maximized and set a goal of making the transition as "seamless as possible." Kates expects there will be problems, partly because of the intertwined involvement of government agencies, insurers and other private entities.

“I do think it’s not going to necessarily be the smoothest transition. There could be gaps and snafus along the way,” she said.

Will vaccines remain free for all?

The federal government has already bought more than 1 billion doses of vaccine from Pfizer and Moderna, according to Kaiser Family Foundation, in a supply expected to last until summer or fall. The vaccines are distributed to states and then local jurisdictions like Ventura County.

The supply means little is expected to change immediately. People who want vaccines will still be able to use the state My Turn website or make appointments directly with pharmacies for free shots and boosters. Vaccines are also available at two public health clinics in Oxnard with an inventory expected to last the rest of the year.

Change is expected when the supply diminishes and cost burdens shift to insurance companies. People without insurance will likely have to pay while those covered privately or through Medicare and Medi-Cal will still be covered through provisions of the Affordable Care Act, also known as Obamacare.

“If you have insurance, you’re pretty much guaranteed free vaccines,” Kates said. “People who are uninsured are not going to get the same protection.”

Will I be able to get tested?

Nearly all of the state-run test sites in the county have already closed and two mobile mini-bus sites are set to shut down Feb. 24 in Oxnard and Thousand Oaks. People can still request free tests mailed to their home from the federal government but that program could end when supplies diminish.

After May 11, private insurers will no longer be obligated to provide eight home tests a month. Tests will still be readily available but won't be free.

"Our estimate is that most people will be faced with at least cost-sharing," Kates said. "We know anytime there's a cost-sharing, it creates a burden for some people."

What about Paxlovid?

Antiviral medications like Paxlovid are used to reduce the chance of serious illness and hospitalizations in people at higher risk because of age or health condition. The medication will continue to be provided free until the federal government’s inventory runs out. Coverage will then depend on insurance.

Uninsured people may have to pay for the medicine, sparking concerns that many will go without, increasing their risk of complications.

“Not everyone can afford it,” said Dr. George Yu, a Camarillo pulmonologist. “These people will get sick.”

Rigoberto Vargas, director of Ventura County Public Health, said officials will be monitoring the COVID care transition and will work to hurdle any issues that emerge with medications, vaccines and tests.

“It may be a little different but I don’t think there will be any significant broad barrier,” he said.

What else will change?

Low-income residents received a minimum of $95 a month more for food during the pandemic in the state's CalFresh program. The payments end in March in Ventura County.

As many as 50,000 Ventura County residents could lose Medi-Cal coverage over 14 months because pandemic measures that eliminated the need for eligibility review and barred programs from dropping members are expiring. State officials have launched an outreach campaign aimed at people who need to update their eligibility status.

The end of the state of emergency will also impact hospitals. They stand to lose waivers that include providing for surge plans that expand intensive care areas, said Jan Emerson-Shea, spokeswoman for the California Hospital Association. She said the waivers are still needed and noted hospitals are also asking the state for $1.5 billion in aid to alleviate the massive financial impact of COVID.

“Hospitals are still in a very precarious situation,” she said. “While we all want the pandemic to be over, it’s not. Hospitals are the place where this shows up.”

Will the money keep coming?

The Federal Emergency Management Agency reimburses the county more than $800,000 a month in costs related to COVID, much of it for a Project Roomkey program that uses local motels to house homeless people at high risk of serious illness. County officials say they are hopeful the reimbursements will continue until the federal emergency ends in May but there is no guarantee.

County officials said the goal is keep the program going until people can be transitioned into other housing programs.

During the pandemic, the health care system was streamlined. Outside of some notable gaps, it was relatively easy to get vaccinated or tested or to find Paxlovid. The end of the emergency orders will likely mean more barriers, said Dr. Peter Chin-Hong, infection disease specialist from UC San Francisco. People will have to plan every step.

Some, who long grew tired of the pandemic, may not try. They may just decide to go without.

“People will give up,” Chin-Hong said.

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.

SUPPORT LOCAL JOURNALISM: To see more stories like this, subscribe here.

This article originally appeared on Ventura County Star: End of COVID emergencies means Ventura County residents may pay more