May 8, 2023 - Podcasts

The end of the COVID-19 Public Health Emergency

The Biden administration is ending its COVID public health emergency on Thursday, and the effects could be tangible for many Americans.

  • Plus, a mass shooting in Texas is the second deadliest in the U.S. this year.
  • And, why voice notes are now rivaling text messages.

Guests: Axios' Adriel Bettelheim and Natalie Daher.

Credits: Axios Today is produced by Niala Boodhoo, Alexandra Botti, Fonda Mwangi and Alex Sugiura. Music is composed by Evan Viola. You can reach us at [email protected]. You can text questions, comments and story ideas to Niala as a text or voice memo to 202-918-4893.

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NIALA BOODHOO : Good morning. Welcome to Axios Today. It’s Monday, May 8th. I’m Niala Boodhoo. Today on the show: a mass shooting in Texas is the second deadliest in the U.S. this year. Plus, why voice notes are now rivaling text messages. But first, what the end of the Covid-19 Public Health Emergency will mean for American healthcare. That’s today’s one big thing.

What the end of the COVID-19 Public Health Emergency means for healthcare

NIALA: The World Health Organization declared the Covid Global Health Emergency over on Friday. And later this week, the Biden administration is ending its Covid Public Health Emergency, and the effects of that could be tangible for many Americans.

Axios’ Adriel Bettelheim is here with the big picture of what healthcare will look like now. Hi, Adriel.

ADRIEL BETTELHEIM: Nice to be with you.

NIALA: Can you remind us broadly what this public health emergency was meant to do?

ADRIEL: Well, you and I have spoken before about the politics behind this emergency declaration, and some would say the symbolic importance of it. But there's just an enormous amount of just plain healthcare delivery riding on this. Telehealth flexibilities, those emergency use authorizations for vaccines and treatments and tests that we've been talking about. And some of these things have already been extended, like some of the telehealth flexibilities, Congress decided to take care of them in some cases, they'll run through the end of this year, maybe through the end of 2024.

But, for example, providers won't be able to prescribe controlled substances via telemedicine without an in-person interaction, unless they at the last minute add some flexibilities or extend that. Some policies that allowed Medicare providers to use FaceTime and Facebook Messenger and WhatsApp and other applications to, to chat with patients will go away. There's the loss of an emergency 20% pay bump for some providers. And, there's allowances that had let providers ship specialty drugs, including cancer drugs, directly to patients. So it's these sort of, you know, real world delivery issues that are gonna change.

NIALA: And what about coverage issues?

ADRIEL: Medicaid, of course, had a provision that sort of insured continuous coverage. Um, this is the safety net program and states and the feds jointly administer it. And they basically in exchange for a larger share of federal contributions, the states were told to keep people on the Medicaid rolls throughout the crisis. Now, the public health emergency is over and some states are already starting to go through what's called redeterminations to see if these people are still eligible. And, uh, yes, there are estimates that, you know, as many as, oh, 15 million by some counts, people could fall off the roles of the safety net program. Some might be able to reapply, but there, there is expected to be a significant surge in the uninsured.

NIALA: What about free Covid tests and free vaccines? Is that going away also then?

ADRIEL: Yeah. There's a requirement for private insurance to cover over the counter in lab tests without cost sharing. That'll end. Some people may have to pay out of pocket for treatments like Paxlovid. On the vaccines themselves, the people on Medicare and Medicaid will pay nothing out of pocket for the shots. Those with private insurance are, are widely expected to continue to pay nothing out of pocket. But again, there will be exceptions.

NIALA: Adriel, what are you expecting will be the biggest healthcare effect of ending this Covid public health emergency? We've talked about quite a few things here.

ADRIEL: What I guess we're watching is whether pulling the plug now could hurt access to healthcare, make it more expensive for some people, and just generally squelch some of the positive changes, uh, that emerged during the Covid crisis. In terms of the precautions, the costs and -- after development of these treatments and tests and vaccines was, was done -- I mean, people were kind of playing with house money. The government was covering the cost and now everything is shifting to the private market. And that means that Covid becomes like so many other infectious diseases and there, you know, come all of these ugly cost benefit trade-offs that go into people's minds. Unless you're on a public program like Medicare and Medicaid, for all those people who have workplace insurance or who are privately insured or who are uninsured, this now becomes, uh, much more of a dollars and cents issue.

NIALA: Adriel Bettelheim is Axios’ Senior Healthcare Editor. Thanks Adriel.

ADRIEL: Thanks for having me.

Texas is the site of the second-deadliest mass shooting in the U.S. this year

NIALA: At least eight people were killed and seven wounded when a gunman opened fire at a mall outside Dallas, Texas on Saturday. The shooter was armed with an AR-15 style assault weapon, and other weapons were also found at the scene. He was killed by a police officer who’d been nearby on a different call. Multiple news organizations are reporting police are investigating the gunman’s possible ties to white supremacy.

The shooting – the second-deadliest of the year in this country – brought the total number of mass shootings in the U.S. this year to 199. That’s according to the Gun Violence Archive. They define a mass shooting as one where at least four people are killed or injured. In what has become a familiar refrain, President Biden this weekend reiterated his call for Congress to ban assault weapons. While no action on this seems close at the national level, at least ten states have passed assault weapon bans of their own – the latest in Washington state, where the ban became law at the end of April.

In a moment, the rise of voice notes.

Why voice notes are rivaling text messages

NIALA: Welcome back to Axios Today. I’m Niala Boodhoo.

Voice notes – self-recorded audio messages sent via app or text – are on the rise, especially among young people. WhatsApp said last year that their users sent an average of 7 billion of these voice messages every day. And a recent poll done on a thousand adults by YouGov and Vox found that 62% of Americans have sent a voice note and around 30% of them do so weekly, daily, or multiple times a day.

Axios’ Natalie Daher is here with why these voice messages are so popular. Hey Natalie.


NIALA: So we should make a distinction here. We're not talking about voicemail, we're talking about voice notes -- or what people might call a voice memo or message -- so what's the appeal of that versus texting?

NATALIE: There are a number of reasons why voice notes are popular right now. First, they are just simply more vivid and descriptive as a storytelling medium. A lot of us are super accustomed to audio forms of consumption, like this very podcast. In addition to other apps like Clubhouse that have propped up over the years, and I think people want a little bit more intimacy, especially coming out of a long period of isolation like Covid.

The second is they're just more efficient. People are on the go, they're walking around a lot, they're carrying their mobile devices. It's a super easy way to stay in touch with friends, give them an update on your life while in motion, and while it doesn't require that friend to actually be available.

NIALA: Yeah, I think that's why I use them, right? Just because it's more efficient if I have a lot I wanna say, and I don't wanna type it all out. But voice notes are also now being used on dating apps?

NATALIE: Yes, I think voice is a huge form of attraction between people. This came up in my conversations with researchers. I think that has come up in conversations with the app companies themselves, from what they hear from users. So it's actually a useful way to discern whether you might be into someone off the app before you spend your time, you know, trudging to your local bar to meet them in person.

NIALA: I think it's interesting, voice -- it's like our oldest medium of expression, but what does it say about the future of technology that we've gone back to it?

NATALIE: Yes, the return of analog has been with us in a lot of different ways, whether it's the return of vinyl that has been surprising for some people... So I think returning to our voice is one of the most basic ways of maintaining communication with people and keeping in touch. Researchers I spoke with pointed out how quickly we perceive how another person is feeling when we hear what they're saying, which is a huge contrast to reading a text message from someone that you're talking to.

And there are a lot of different elements of voice that give us insight into how someone is feeling. Those qualities include pitch, speed, pace, loudness, intonation, and that creates more intimacy between the listener and the speaker. One might feel a little more heard, and the other feels like they can tap more into the person's feelings who's speaking to them. And I think that that's really lovely and maybe feels too quaint in a world where we have Chat GPT generating audio comms.

NIALA: We'll include a link to Natalie's reporting in our show notes. Thanks Natalie.

NATALIE: Thank you, Niala.

NIALA: That’s all we’ve got for you today! Remember you can always send me a voice memo – you can send it to (202) 918-4893. I’m Niala Boodhoo, thanks for listening, stay safe and we’ll see you back here tomorrow morning.

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