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Advocacy/Public Policy

Advocates Warn on Hasty End to the Public Health Emergency

By David M. Goldfarb, Esq., CAE

The end of the public health emergency could end in July. Here's what you need to know about what this could mean for your clients.


To date, COVID-19 has spread to over 79.5 million Americans resulting in over 965,000 deaths. While Americans feel fatigued and some politicians in charge hope to declare victory, cases continue. Despite the ongoing problems associated with the pandemic, states have reported that the U.S. Department of Health and Human Services plans to end the COVID-19 Public Health Emergency (PHE) in July.

The end of a “public health emergency” is not a mere declaration. Emergency authorities old and new are tied to its end. Most importantly, Section 6008 of the Families First Coronavirus Response Act (FFCRA) allowed states to receive a 6.2% Federal Medical Assistance Percentage (FMAP) increase through the end of the PHE. In exchange, states must maintain continuous coverage and abide by maintenance of effort requirements (MOE). The increase in funds has allowed states to cover new costs associated with the pandemic and make use of emergency authorities, such as Section 1915(c) Appendix K and 1135 Waivers.

The Urban Institute recently estimated that approximately 15 million individuals could lose Medicaid and CHIP coverage once the continuous eligibility requirements get lifted. At the end of the PHE, states will have a year to initiate the renewal process and 14 months to complete it. With 85 million Americans enrolled in Medicaid and CHIP, advocates fear that states are woefully unprepared to handle the workflow. A recent Kaiser Family Foundation report noted that only half of states had a plan for how to prioritize outstanding eligibility and renewals.

In Mid-March, NAELA organized a letter with 30 other aging and disability organizations raising concerns about a hasty end to the PHE. The letter requests that “HHS provide at least 120 days advance notice when it intends to lift the COVID-19 PHE.” In addition, the letter also urges HHS to keep the PHE in place until “sufficient steps have been taken to address the direct care workforce crisis and ensure that people with disabilities and older adults are protected during the redetermination process.”

The letter notes several additional factors for requiring more time. First, the workforce crisis impacting home and community-based services. “Low compensation paired with the new stresses and risks of providing close-contact services has resulted in turnover rates ranging as high as 79.5%,” according to the letter. Ending the PHE and associated funding increases too soon could therefore “put individuals at risk of institutionalization due to lack of adequate direct care supports.”

Second, the Social Security Administration’s (SSA) local offices have been closed for nearly two years. Social Security, particularly SSI, beneficiaries have had issues sorting out eligibility issues with 67.8 million calls left unanswered in 2020. Given the close links between SSI and Medicaid, this increases an already hazardous situation individuals with disabilities of all ages will likely face during the renewal period.

The good news is that NAELA is preparing you for the coming end of the PHE. To learn more about how this will impact your clients and practice be sure to check out our recorded webinar from March 22, ­COVID-19 Public Health Emergency, available by searching on 

About the Author
David M. Goldfarb, Esq., CAE, is Director of NAELA Advocacy.
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