HJAR May/Jun 2023

44 MAY / JUN 2023 I  HEALTHCARE JOURNAL OF ARKANSAS POLICY COLUMN POLICY NUMEROUS POLICIES implemented during the emergency are ending or being phased out, including policies affecting access to COVID-19 testing, treatment, and vac- cines; telehealth flexibilities; and Medicaid enrollment. TESTING During much of the public health emer- gency, people with private health insurance or Medicare were eligible for up to eight free at-home COVID-19 tests per month. Insur- ers were also required to cover laboratory COVID-19 tests with no cost-sharing, even when the tests were performed by health- care providers outside of the insurers’ net- works. Coverage for testing is changing in different ways for people with different kinds of insurance. People with private insurance may be subject to cost-sharing for at-home and lab tests, depending on their plans. People withMedicaid — includingArkan- sans enrolled in ARKids First or the state’s People without insurance may also be able to obtain free or reduced-cost tests from safety-net providers or local nonprofit orga- nizations; otherwise, they will be responsible for the full cost of all testing. TREATMENT People generally have not had to pay out of pocket for antiviral pills such as Paxlovid because they were purchased by the federal government, but that supply will soon be exhausted, and Congress has not provid- ed funding to purchase more. People with private insurance can expect to face cost- sharing when the supply of government- purchased antiviral drugs runs out. Most private insurers voluntarily waived out-of-pocket costs for other COVID-19 treatments early in the pandemic, but by late 2021 most of them had reimplemented cost-sharing, so no changes are expected for people with private insurance who obtain COVID-19 treatments other than antiviral drugs. SCALING DOWN THE COVID-19 RESPONSE: Policy Changes Associated with the End of the Public Health Emergency With the end of the national COVID-19 public health emergency, the U.S. begins the transition into the non- emergency phase of this pandemic. COVID-19 is still with us, and we should continue taking appropriate precautions, but the government response to the pandemic is scaling down in recognition of the fact that most Americans now have some protection due to vaccination, infection, or both. Medicaid expansion program, Arkansas Health and Opportunity for Me, also known as ARHOME — will continue to be eligible for free COVID-19 tests and test-related services through Sept. 30, 2024. After that, states could limit the number of covered tests or impose some level of cost-sharing. Those enrolled in traditional Medicare become responsible for the full cost of at- home tests with the end of the public health emergency. However, laboratory tests con- ducted by healthcare providers will con- tinue to be covered under Medicare Part B with no cost-sharing for beneficiaries. Those enrolled in Medicare Advantage plans may experience cost-sharing changes, depend- ing on their plans. Congress is no longer funding the fed- eral program that periodically allowed all U.S. residents, including those without in- surance, to obtain free at-home COVID-19 tests through the mail. The federal govern- ment has said it may continue to distribute its stockpile of tests while the supply lasts.