As of May 2023, the Federal COVID-19 Public Health Emergency (PHE) declaration has ended and the United States has entered a post-pandemic era. Though COVID-19 continues to affect people across the country, hospitalization rates and immunity coverage in communities have considerably improved. According to the Centers for Disease Control (CDC), vaccines, treatments, and testing will remain available while coverage for COVID-19 testing and national surveillance will be reduced.

Despite the CDC no longer considering COVID-19 a public health emergency, the pandemic will undoubtedly have lasting impacts. In the United States, as of November 2023, there have been 6,522,156 total hospitalizations and 1,156,484 total deaths due to COVID-19. As covered by previous Vertices articles, the pandemic has exacerbated existing geographic, socioeconomic, and racial health disparities. Exploring the lasting impacts of COVID-19 and ongoing policy changes can allow us to understand existing disparities—especially trends in racial health disparities—as we emerge from the post-pandemic era.

Racial health disparities were particularly exacerbated during the pandemic, with Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian communities experiencing higher cases and deaths due to COVID-19 compared to white people. Underlying determinants that impact access to healthcare and ongoing health disparities persist during the post-pandemic era. In a 2022 Kaiser Family Foundation survey, one in five Black adults and one in five Hispanic adults reported unfair treatment due to their race while seeking healthcare for themselves or their family members. Additionally, more individuals are uninsured in Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian non-elderly populations compared to their white counterparts. Not only was this statistic likely exacerbated during the pandemic, but it also could have affected treatment-seeking behavior and access to screening and treatment. In fact, Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian populations experienced a greater decline in life expectancy compared to white counterparts as a consequence of the pandemic. Though the pandemic highlighted such disparities, Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian populations already experience disproportionately higher rates of chronic disease, cancer, and maternal mortality that persist in the post-pandemic era.

Since the PHE declaration ended, certain interventions and government funding have rolled back regarding healthcare coverage, disproportionately impacting healthcare access for people of color. At the start of the pandemic, Congress passed the Families First Coronavirus Response Act (FFCA), which temporarily required people to be continuously enrolled in Medicaid programs and the American Rescue Plan. This mandate increased health insurance coverage by lowering or eliminating health insurance premiums for low-middle-income families. However, provisions that expanded health insurance coverage ended in 2023, resulting in coverage loss for “5 to 14 million people,” effectively reversing the increase in healthcare coverage during the pandemic and disproportionately impacting Black and Hispanic populations. For populations with language barriers or disabilities, expired healthcare coverage also poses an obstacle that will reduce healthcare access. With this rollback of benefits introduced during the pandemic, racial health disparities will only continue to increase. 

However, the United States has also refocused on some burdens of disease that disproportionately impact Black, Hispanic, American Indian or Alaskan Native, and Native Hawaiian populations. In July 2022, the Biden-Harris administration extended its promise to reduce maternal mortality among Black women with the Maternity Care Action Plan to reduce equities for people during pregnancy. Specifically, under the Maternity Care Action Plan, the plan ensures continuity in health insurance coverage before, during, and after pregnancy. Additionally, the plan seeks to expand maternal healthcare coverage across states in closing geographic disparities along with working with providers to improve overall quality of care. As of April 2023, the majority of states have made efforts to expand postpartum coverage by extending Medicaid coverage to up to one year postpartum. Additionally, the Consolidations Appropriation Act of 2023 requires all states to implement one year of continuous coverage for children. 

Though COVID-19 is no longer declared an emergency, it is crucial to consider how disparities have changed for members of marginalized communities. With the reduction in COVID-19 cases and mortality, funding and policies supporting marginalized communities during the pandemic will also be reduced. Evaluating how healthcare access and racial health disparities have changed can highlight what populations demonstrate continued need and which health issues should be prioritized as we emerge from the COVID-19 pandemic. 

Above: Image courtesy of Penn State Harrisburg.