After more than three years, the COVID-19 public health emergency is set to end, after the federal government chose not to renew it. This means a lot of changes are on the way, which will affect everything from free vaccines and tests to food assistance programs.
WASHINGTON — The formal end of the national public health emergency Thursday is largely a symbolic and psychological step, representing the country's formal emergence from the COVID-19 pandemic.
Behind the scenes, several core aspects of the U.S. pandemic-era emergency safety net are also coming to a close, from extra food assistance to automatic re-enrollment in Medicaid. While these measures were designed to be temporary, their expiration is producing hardship and confusion.
"People are starting to get their jobs back, but it's still not all the way back and everything is more expensive than before the pandemic," said Radha Muthiah, president of the Capital Area Food Bank. "The people we serve always seem to be playing catch-up."
At Thursday's White House briefing, press secretary Karine Jean-Pierre took note of the end of the public health emergency. “The work won't stop,” she said, with the administration working to ensure continued access to COVID-19 vaccines, treatments and tests and to tackle long COVID.
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Safety net programs gave Americans a lifeline during the height of the pandemic. The child tax credit was increased, unemployment benefits and food assistance were expanded and a federal moratorium on eviction kept people in their homes even if they were unable to pay rent.
The Census Bureau reported last year that COVID-19 relief efforts and others sharply reduced childhood poverty, but these programs have now expired.
The impact is being felt.
Perhaps the fastest shock to the system has come in the SNAP program, commonly known as food stamps. During the pandemic, all SNAP recipients had their benefits boosted though an emergency allotment program. The duration of those extra payments was originally tied directly to the duration of the public health emergency, but that was changed in December 2022 and the final pandemic-boosted SNAP payments went out at the end of February.
The average family started receiving about $90 less per month in March, though some households dropped by up to $250, according to a Center on Budget and Policy Priorities study.
Muthiah said her organization distributed 13% more fruits, vegetables, meat and canned goods in March, the month after the extra SNAP benefits expired. In times of financial hardship, she said many families in need prioritize non-negotiable items like rent or gas while turning to charities to fill holes in their food budgets.
"We're seeing a cumulative effect of things being rolled back," said Muthiah, who estimated that 300,000 families in her food bank's service area are impacted.
The end of the extra SNAP assistance led to confusion and frustration. Allison Miles-Lee, an attorney with the D.C. charity Bread for the City, said there has been a spike in demand for legal services as SNAP recipients struggle to understand how their new — theoretically back to normal — monthly payment was decided. In many cases, the amounts are based on sometimes obsolete information on family size, income or number of dependents.
"A lot of people just didn't report or update their information for three years," Miles-Lee said. "Now they're panicked and just sort of flying blind."
Tina Robinson is one of those confused SNAP recipients. The 49-year-old D.C. resident used to receive $100 per month through SNAP. During the pandemic that rose to $200 per month but, starting in March, her SNAP benefits abruptly dropped to $6 and she doesn't know why.
"What exactly can you buy with $6," Robinson asked as she waited in line for free groceries Wednesday morning at Bread for the City's charity food pantry. "That's almost worse than sending me zero, because it probably took $20 worth of government employee time to get that $6 to me."
Robinson said she tried to get some clarity by calling the D.C. Department of Human Services. "They don't answer their phones," she said.
She says she never received a letter notifying her of the impending benefits reduction.
Helena Smith, a 63-year-old retiree, says she received a letter and knew her benefits would drop by more than $100. That difference in her food budget was enough to bring her back to the food pantry.
"It really did help a lot during the pandemic and I'm grateful for it," Smith said. "I knew it couldn't last forever, but it was a lot to lose all at once."
A similar, slower moving, process is happening with Medicaid, as dozens of states begin a review process that will remove as many as 14 million people from the health care program.
Before the pandemic, people would regularly lose Medicaid coverage if they started making too much money to qualify for the program, gained health care coverage through their employer or moved to a new state. The federal government prohibited states from kicking people off Medicaid during the pandemic, even if they were no longer eligible.
Now dozens of states are launching reviews of their Medicaid recipients and removing those deemed ineligible. The process could take up to a year to complete, though some states are moving faster than others; Arizona, Arkansas, Florida, Idaho, Iowa, New Hampshire, Ohio, Oklahoma and West Virginia are among the states aiming to begin removing ineligible Medicaid recipients as early as this month.
Jennifer Wagner, director of Medicaid eligibility with the Center on Budget and Policy Priorities, said the process is already being marked by confusion and miscommunication. She noted one state is requiring recipients to fill out a 46-page form.
