President Joe Biden announced he will end the declarations of national emergency and public health emergency (PHE) that began in 2020 under the administration of President Donald J. Trump. The declarations are set to expire on March 1 and April 11, respectively, but those will be extended a final time to May 11.

The wind-down aligns with the administration’s commitment to give at least 60 days’ notice prior to termination of the PHE. It also provides for a smoother transition than ending the emergency declarations by legislation in Congress, according to the White House.

Administration policy

The president’s Office of Management and Budget (OMB) released the statement of administration policy on Jan. 30, citing two pending resolutions in the U.S. House of Representatives. The bill known as House Resolution (HR) 382 would terminate the PHE, declared Jan. 31, 2020, while House Joint Resolution 7 would end the national emergency declared March 13, 2020.

“First, an abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system – for states, for hospitals and doctors’ offices, and most importantly, for tens of millions of Americans,” the statement said.

OMB cited the Medicaid special rules that provided money for states to continue Medicaid coverage for people during the pandemic. Congress in December “enacted an orderly wind-down of these rules to ensure that patients did not lose access to care unpredictably and that state budgets don’t face a radical cliff,” the president’s statement said.

A sudden stop would lead to “chaos” for patients, hospitals, and nursing homes, with delays in care and payments. Patients relying on telehealth services, and those with behavioral health needs and rural patients, would be most affected, according to the White House.

Representative leader responds

The 2023 federal budget extended telehealth and “hospital at home” provisions through December 2024. It gave states clear timelines to deal with people on Medicaid and on winding down enhanced federal funding for Medicaid, said Rep. Cathy McMorris Rodgers, R-Washington. As chair of the House Energy and Commerce Committee, Rodgers published her remarks supporting the COVID-19 emergency legislation in advance of the Committee’s organizational meeting Jan. 31.

The risk of contracting COVID-19 remains, but has decreased significantly through vaccinations, treatments, and natural immunity, Rodgers said.

“It is now a risk Americans should be calculating for themselves and their families,” Rodgers said. “Nothing worth doing is without risk – there is a risk to driving to work, playing in a rec league soccer team with friends – and COVID-19 is now one of those risks that Americans can review and balance for themselves.

“The American people have moved on from government making that risk assessment for them and want their lives to get back to normal,” Rodgers said.

Vaccine mandates

Biden and Rodgers both remarked on COVID-19-related legislation known as the Freedom for Health Care Workers Act, House Resolution 497. The bill would void the requirement for health care staff to be vaccinated against COVID-19 in health centers that participate in Medicare and Medicaid.

If Congress passes it, the president said he will veto it to avoid putting patients at unnecessary risk. Rodgers blasted the rule, arguing it added to distrust of public health officials and institutions, while not preventing transmission of the COVID-19 virus.

Immigration

Health care became part of enforcement and debate about immigration policy through Title 42, a 1944 rule that allowed U.S. Border Patrol agents to turn away immigrants at the U.S.-Mexico border.

The president said he supports ending Title 42, but HR 382 would end it immediately with the PHE, “effectively … requiring the administration to allow thousands of migrants per day into the country immediately without the necessary policies in place.”