Intended for healthcare professionals


Covid-19: US will end public health emergency on 11 May, says Biden

BMJ 2023; 380 doi: (Published 01 February 2023) Cite this as: BMJ 2023;380:p262
  1. Janice Hopkins Tanne
  1. New York

President Joe Biden has announced to the US Congress that he will end the country’s covid-19 public health emergency on 11 May, although about 500 Americans are currently dying every day from covid-19. He also plans to end the related national covid-19 emergency.1

In contrast, the World Health Organization said on 27 January that the covid-19 pandemic was still a public health emergency.2

The US administration’s statement said that extending the emergencies until May would provide time for an orderly transition. Ending the emergencies will mean that many Americans will lose the health insurance provided through the Medicaid programme, which helps people on low incomes and was extended during the pandemic. Many others will find that they no longer get free tests, treatments, or vaccines.

The new rule will also change restrictions on immigrants at the border.

The US covid emergencies, initiated by former president Donald Trump, were scheduled to end on 1 March and 11 April this year. Now both will end on 11 May. Biden’s announcement came as the Republican majority House of Representatives was planning to vote on measures to end the emergencies immediately.3

The White House said that immediately ending the emergencies “would create wide ranging chaos and uncertainty throughout the healthcare system—for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans.” The statement noted that the Medicaid system had “operated under special rules to provide extra funding to states to ensure that tens of millions of vulnerable Americans kept their Medicaid coverage during a global pandemic.”


The time extension will provide an opportunity for states, healthcare systems, and patients to adjust to the new situation. States will lose billions of dollars in funding that they received to help with the pandemic. Unless hospitals and nursing homes adapt they will lose the flexibilities they were given during the pandemic, and patients and military veterans who rely on telehealth will lose access to critical services and medicines. The people most acutely affected would be those with behavioural needs and patients in rural areas.

In May Americans will find that the covid tests, treatments, and vaccines that were provided free during the pandemic will now need to be paid for—either by their health insurance plans, Medicare (government health insurance for elderly people), or Medicaid, or out of their own pockets.

The end of the public health emergency will also end the title 42 policy at the border.4 Title 42 deals with public health, social welfare, and civil rights. It allows the federal government to take emergency action to keep communicable diseases out of the country and had not been used since 1929. Trump’s former administration invoked the law to limit the number of immigrants at the border quickly and without considering them for asylum, on the grounds that they might bring covid-19 into the US. More than two million people have been expelled since Trump’s action. The Biden administration has previously tried to end the policy.

The White House’s statement says that the number of migrants crossing the border has halved since the current administration put in place a plan to deter irregular migration from Cuba, Haiti, Nicaragua, and Venezuela. It said, “The administration supports an orderly, predictable wind-down of Title 42, with sufficient time to put alternative policies in place.”

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