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# Biden Administration Sets May 11 End for COVID-19 Emergencies, Beginning a 100-Day Health-System Transition
- URL: https://www.theamericanquorum.com/taq-historical-2023-02-04-healthcare/
- Published: 2023-02-05T04:59:00.000Z
- Updated: 2023-02-05T04:59:00.000Z
- Description: The Biden administration plans to end the COVID-19 national and public health emergencies May 11, starting a transition that will unwind waivers, coverage rules and emergency-era health policies.
- Author: Kenneth R. Deans Jr.
- Tags: Healthcare, #Import 2026-08-31 21:58

The Biden administration will end the federal COVID-19 national emergency and public health emergency on May 11, setting a firm date for the United States to unwind many of the legal and regulatory tools that have shaped health care since early 2020\. The announcement, made Jan. 30 in a statement opposing congressional efforts to terminate the declarations immediately, gives hospitals, insurers, states, clinicians and patients roughly 100 days to prepare for a transition that will affect payment rules, testing, telehealth, emergency waivers and other parts of the health system.

The White House said the declarations would be extended until May 11 and then terminated together. Its [policy statement](https://www.presidency.ucsb.edu/documents/statement-administration-policy-hr-382-bill-terminate-the-public-health-emergency-declared?ref=theamericanquorum.com) argued that ending them abruptly would create uncertainty for states, providers and tens of millions of Americans, and noted that the administration had previously committed to giving at least 60 days’ notice before ending the public health emergency.

## Two emergencies created different authorities

The national emergency and the public health emergency are legally distinct. The national emergency, first declared in March 2020, enabled federal agencies to use a range of emergency authorities. The public health emergency under Section 319 of the Public Health Service Act supported health-specific waivers and flexibilities, including changes in Medicare and Medicaid rules and emergency arrangements for health-care delivery.

An [Associated Press report](https://apnews.com/article/2a80b547f6d55706a6986debc343b9fe?ref=theamericanquorum.com) described the announcement as a major shift from crisis management toward a more conventional response to COVID-19, while emphasizing that the virus continues to cause illness and death. The administration’s position is not that SARS-CoV-2 has disappeared, but that the extraordinary legal framework can now be wound down on a defined schedule.

The distinction among emergency authorities also means May 11 will not terminate every COVID-related policy. A detailed [KFF analysis](https://www.kff.org/covid-19/what-happens-when-covid-19-emergency-declarations-end-implications-for-coverage-costs-and-access/?ref=theamericanquorum.com) notes that the Food and Drug Administration’s separate authority to issue Emergency Use Authorizations for vaccines, drugs and diagnostics does not automatically expire with the Section 319 public health emergency. Likewise, some liability protections and congressionally extended policies have different expiration dates.

## Testing, treatment and coverage will change unevenly

For patients, the transition will be complicated because not every benefit changes at the same time. A Feb. 3 [KFF policy brief](https://www.kff.org/covid-19/the-end-of-the-covid-19-public-health-emergency-details-on-health-coverage-and-access/?ref=theamericanquorum.com) explains that access to federally purchased vaccines will remain free while government supplies last, but the rules governing tests, treatments and cost sharing will increasingly depend on insurance status and program-specific requirements.

Some pandemic-era coverage protections are already on a separate timetable. Congress ended the Medicaid continuous-enrollment condition as of March 31, allowing states to resume eligibility redeterminations beginning in the spring. That means millions of beneficiaries will face coverage reviews independent of the May 11 emergency expiration. The timing is important because the health system will be managing enrollment transitions at the same time providers are preparing for the end of emergency waivers.

The American College of Cardiology summarized several clinical and payment effects in a Jan. 31 [policy update](https://www.acc.org/latest-in-cardiology/articles/2023/01/31/20/28/biden-administration-announces-covid-19-emergencies-ending-may-11?ref=theamericanquorum.com), including changes to COVID-19 testing and treatment coverage and the end of certain enhanced inpatient payments. The precise effect will vary across Medicare, Medicaid, private insurance and the uninsured.

## Hospitals and clinicians must unwind emergency waivers

During the pandemic, the Centers for Medicare & Medicaid Services used emergency authority to relax or modify numerous requirements governing where care could be delivered, how providers could be enrolled and how facilities could meet certain conditions of participation. Those flexibilities helped health systems respond to staffing shortages and surges, but many are tied directly to the public health emergency.

The American College of Emergency Physicians described the implications in a Feb. 2 [analysis](https://www.acep.org/federal-advocacy/federal-advocacy-overview/regs--eggs/regs--eggs-articles/regs--eggs---february-2-2023?ref=theamericanquorum.com). It noted, for example, that certain independent freestanding emergency departments temporarily allowed to participate in Medicare and Medicaid under emergency arrangements will need to return to ordinary enrollment and certification rules when the public health emergency ends. ACEP also highlighted the expiration of the 20% Medicare inpatient add-on payment for COVID-19 cases.

Not every innovation will disappear. Congress has already extended some telehealth provisions and the Acute Hospital Care at Home initiative beyond the public health emergency. That creates a more selective transition: some emergency practices are being absorbed into temporary or longer-term statutory policy, while others will revert to pre-pandemic rules.

## A managed end rather than an abrupt stop

The administration’s 100-day runway is designed to give agencies and providers time to publish guidance, revise billing systems, update patient communications and determine which flexibilities can continue under other authorities. The central operational challenge will be distinguishing policies that end May 11 from those Congress has separately extended or that depend on different legal declarations.

The announcement also arrives as political disagreement over the emergency status intensifies. House Republicans are moving legislation that would end the declarations sooner, arguing that the country no longer needs emergency governance. The White House opposes that approach, contending that an immediate termination would disrupt health coverage and provider operations.

The May 11 date therefore represents both a public-health milestone and a regulatory deadline. After nearly three years, the federal response is moving away from emergency authorities toward routine insurance, payment and public-health mechanisms. But the transition will not be a single switch. For patients and providers, the practical consequences will unfold policy by policy — across testing, treatment, reimbursement, Medicaid, telehealth and the many waivers that have quietly supported health-care delivery since 2020.