How the end of the public health emergency affects Wayne County

Health care changes that both providers and patients have grown used to during the pandemic end tomorrow with the expiration of the COVID-19 public health emergency.

Why it matters: The expiration marks the end of more than three years of additional spending to combat the pandemic.

• A variety of different health care aspects will be impacted, like private insurance no longer being required to cover testing, or changes to when you're allowed to have telehealth visits rather than in-person.
• While the vaccine is still free, that could change in the future, Dennis Cunningham, medical director of infection control and prevention at Henry Ford Health, tells Axios. "It's certainly still a dynamic situation."

What's happening: Home or lab COVID tests may not be free after tomorrow, depending on your health coverage.

• The requirement for private insurance to cover tests without cost-sharing will end — although the Department of Health and Human Services says it's encouraging companies to keep covering the tests.
• Wayne County health director Abdul El-Sayed tells Axios the county is fully funded to continue providing pandemic-related care through the end of 2024.
• He says that vaccines, treatment and testing are "still going to be free at the point of care, though, the way that they're being provided is going to change in terms of how money changes hands, but the user experience is going to be the same."

Meanwhile, people on Medicaid will still have coverage for lab tests without cost-sharing until Sept. 2024. After that, the coverage will be up to individual states.

• COVID vaccines will continue to be covered without cost-sharing for those on Medicare and Medicaid, and for most of those with private insurance, although there may be some exceptions on private plans.
• "I don't think people should expect to see how they're treated change. It's going to be more on the back end of who's paying for things," Cunningham says.

What's more: More than 400,000 Michiganders are at risk of losing their health insurance through Medicaid. The federal health emergency barred states from removing anyone from Medicaid during the pandemic, so more than 3 million clients are now being required to prove they're still eligible for benefits

• They're disproportionately residents of Wayne County, El-Sayed says.

Zoom in: Pandemic practices have already begun changes as hospital systems like Henry Ford, DMC and Michigan Medicine eased masking policies last month. Most counties are at low community spread while registering all-time lows in the number of COVID deaths.

What we're watching: El-Sayed tells Axios that public health officials are still anxious to monitor COVID transmission through the fall.

• "Do we see a seasonal increase in cases and hospitalizations or do we continue to see low levels that allow us to feel like we really have turned the page?"