By Brooklyn Roberts
The federal government quietly put an end to its Public Health Emergency (PHE) for COVID-19 earlier this month, following 13 PHE renewals since the initial order was issued in January 2020. The PHE, which outlived the public’s pandemic fears, was used to justify government lockdowns, mask mandates, and more. At the same time, the PHE brought several positive changes in state health care policy. Now that the PHE has come to an end, states should consider moving several temporary reforms to the permanent file.
At the start of the pandemic, states lifted or relaxed telehealth laws through emergency declarations tied directly to the PHE. This allowed patients to receive video consultations, medical data to be stored and forwarded, and remote patient monitoring. Arizona, for example, expanded the limits of telehealth to include audio-only encounters, eliminated in-person requirements for drug prescriptions, and approved the use of store-and-forward technologies. Those changes were soon made permanent when Gov. Ducey signed H.B. 2454. States that embraced similar allowances should follow suit before their temporary telehealth laws revert back to pre-COVID status. (RELATED: ALEXANDER GRAY: Chinese Drugs Are America’s Most Dangerous Addiction)
Another area in need of addressing was licensure, or how the authorities regulate and license professionals like nurses and physicians. While telehealth provided a platform for patients to meet with their regular doctors, those options were limited when either the doctor or the patient moved to another state. Once again, H.B. 2454 addressed this shortfall in The Grand Canyon State by allowing professionals licensed from other states to practice medicine, including via telehealth, throughout Arizona. By authorizing health care providers to practice on their patients, no matter where they practiced or where they lived, states were able to offer the best possible care.
Like every other industry, the number of health care workers took a tremendous hit. That impact was felt more in rural areas than anywhere else as career changes and family adjustments caused many to leave the field. That raised the question of whether health care workers were truly practicing to the full extent of their medical training. A number of states responded by adjusting their scope of practice laws, which eased staff shortages and allowed hospitals to better serve their patients. While the pandemic may be at an end, states would still benefit from allowing the changes in their scope of practice laws to remain in place.
There was also a significant change in Medicaid during the pandemic. In 2020, the federal government offered an increase in the Federal Medical Assistance Percentage (FMAP) to states that agreed not to remove anyone from their Medicaid rolls for the duration of the PHE. Now that PHE has come to an end, states are finally allowed to re-examine their Medicaid rolls and re-verify the eligibility of their enrollees. It’s also welcome news for those who acquired employer-provided coverage but were prevented from leaving Medicaid during the PHE.
This has the potential for significant savings at the state level. The vast majority of the waste, fraud, and improper spending in Medicaid comes from a failure to verify eligibility. In fact, the 2022 Medicaid improper payment rate was 15.6%. In dollars that translates into an overall cost of more than $80 billion. Now that the FMAP increase is no longer available, states will be free to correct any miscues.
The end of the PHE provides states with the opportunity to reassess and perform a little spring cleaning. While not every new idea that sprung to life during the pandemic was a great idea, some of the fixes developed in the health care arena present both patients and providers with some much-needed solutions. It’s time for the states to adopt what works, save a little money, and provide their citizens with the health care they deserve.
Brooklyn Roberts is Health and Human Services Task Force Senior Director at the American Legislative Exchange Council.
