California's COVID State of Emergency Ends Today. What Does That Actually Mean for You?

Today, California’s COVID-19 state of emergency officially comes to an end.

Since March 2020, this statewide emergency declaration has given Gov. Gavin Newsom the power to suspend or change laws in California to fight the spread of COVID. Now, after almost three years, the state is winding down its state of emergency.

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The move has been characterized as “a symbolic end” to the pandemic in California, and a “decision [that] will have little practical impact on most people’s lives.” And it’s certainly true that most of the pandemic-related orders Newsom has issued since March 2020 — almost 600 of them — have been lifted.

But it’s not entirely accurate to say that this move will have zero implications for California and the way COVID is handled — and perceived. Added to the mix is the fact that even if people are aware that the state of emergency is ending, they might not really know exactly what that entails — or how it could affect them personally.

So what does California ending its state of emergency mean for you?

The federal state of emergency is ending, too — which also affects Californians

In January, the White House announced that the federal state of emergency for COVID will end on May 11 — over two months after California ends its own. And to complicate matters a little more, there are actually two federal emergencies ending May 11: the national emergency, and the public health emergency.

The end of these national emergencies will have big effects upon nationwide funding for COVID vaccines and testing.

Thanks to laws that have been passed in California in the last few years (more on this below), Californians will at least be able to keep a lot more COVID coverage than folks living in other states. But May 11 is a date people in California still need to know, because some of those laws are tied to the end of the national-level declarations.

Looking beyond the end of both the statewide emergency and the nationwide public health declaration, Gov. Newsom’s office says his administration intends to seek lawmakers’ approval to actually preserve two of the emergency provisions enabled by the 2020 state of emergency in California. These specifically deal with allowing different health care workers to perform certain COVID-related functions (for nurses, it’s dispensing COVID medications like Paxlovid; for lab workers, it’s processing COVID tests on their own).

For insured people in California, most COVID coverage won’t change — yet

California has recently enacted several laws that force insurers to keep covering COVID care even after the state and federal states of emergency wind down.

State Senate Bill 510 requires insurers in California to keep covering COVID costs like testing and vaccination after the national emergency ends. On the national level, the White House’s COVID-19 Response Coordinator Dr. Ashish K. Jha has promised that COVID vaccines will remain free in the U.S. for insured people as a preventive service covered under the Affordable Care Act of 2010.

Meanwhile, another California law — State Bill 1473 — requires insurers to not only keep covering the costs of COVID therapeutic treatments like Paxlovid, but also to keep reimbursing their members for the costs of up to eight over-the-counter COVID tests a month. But this law only keeps the current situation in place until six months after the end of the federal emergency on Nov. 11.

After that date, if you want Paxlovid or to get reimbursed for COVID tests by an insurer, you’ll have to make sure you are obtaining these services “in-network.” And at this stage of the year, specific details about what that’ll look like in practice come November are lacking.

For uninsured people, COVID care will probably get (even) more confusing

As with so many aspects of the pandemic, it looks like things will become less clear — and often plain harder — for uninsured folks. Jha has given assurances that “[o]n May 12, you can still walk into a pharmacy and get your bivalent vaccine. For free,” and that the same will hold for obtaining Paxlovid.

But he also wrote that, longer term, “likely over the summer or early fall,” the country would “transition from US government distributed vaccines and treatments to those purchased through the regular healthcare system,” and that the White House was “committed to ensuring that vaccines and treatments are accessible and not prohibitively expensive for uninsured Americans.”

Which does not necessarily mean they will be free.

Some California cities also have their own public health emergencies — with their own effects

California ending its state of emergency may well spur the remaining cities that have kept their own states of emergencies to end theirs, too — which may have effects of their own upon residents.

For example, San Francisco also still has its own Public Health Emergency Declaration for COVID in effect, and several programs for San Francisco residents (and people who work in the city) are dependent on that declaration being in effect. But on Thursday, San Francisco officials announced that the city’s public health emergency would be coming to an end at the same time as the state’s, on Feb. 28.

Among the impacts of this decision: As of Oct. 1, 2022, San Francisco’s Public Health Emergency Leave (PHEL) offers employees who work for certain San Francisco employers up to 80 hours of paid leave for COVID-related reasons. Now that San Francisco’s public health emergency is ending at the end of February, city residents and workers will no longer be able to claim this paid sick leave for COVID starting March 1.

Not everyone thinks this is a good idea

In the announcement about California ending its state of emergency on Feb. 28, administration officials acknowledged the crucial role played by these emergency powers in fighting the pandemic — but framed the expiration as a logical step that was coming at the right time.

Gov. Newsom called the state of emergency “an effective and necessary tool that we utilized to protect our state,” saying that now, “with the operational preparedness that we’ve built up and the measures that we’ll continue to employ moving forward, California is ready to phase out this tool.” Dr. Mark Ghaly, secretary of the California Health and Human Services Agency, spoke of California moving “into this next phase” with the winding down of the state of emergency, and how “the infrastructure and processes we’ve invested in and built up will provide us the tools to manage any ups and downs in the future.”

But some disagree it’s the right time to end the state’s emergency powers. Carmela Coyle, head of the California Hospital Association, told The New York Times earlier this month that February was “a terrible time to end the public health emergency,” because of ongoing strain on California’s hospitals.

Coyle said that Newsom’s emergency declaration had helped state hospitals better cope with high numbers of patients — by permitting facilities to temporarily expand treatment spaces to deal with larger numbers of patients — and also staffing shortages, by allowing hospitals to hire workers from out of state.

“The discontinuation of those declarations of emergency has to be thoughtfully planned and transitioned,” Coyle told The New York Times. “Otherwise, it leaves hospitals caught in the middle in this debate of whether the pandemic is over or not.”

Speaking to KQED Forum this month, UCSF infectious disease specialist Dr. Peter Chin-Hong struck a cautious note, saying that while he believed it is essentially “the right time” for California and the White House to end these emergency declarations, there were still “repercussions that we have to be prepared for.”

“In a fractured medical health care system, I’m worried that people are going to fall between the cracks,” said Chin-Hong, noting that Californians would still be “generally, decently protected as a people, compared to other areas” in the U.S. “The biggest worry that I have is that it will be confusing,” he said, pointing to the potential for contradictory signals around COVID testing, vaccination and treatment among people who don’t know whether they’ll face steep out-of-pocket costs for this care and might just give up trying to access it.

Chin-Hong also acknowledged the risks of how the states of emergency ending could falsely signal to the general public that COVID no longer posed them — or others — any threat. “The worst thing,” he said, would be “that people think that it means that it’s all over until next winter.”

And finally, just to make everything even more complex …

Several other COVID programs are ending in California — but that’s not (entirely) due to the state of emergency

There are a number of pandemic-related programs and support schemes that are winding down alongside the ending of California’s (and the nation’s) states of emergency, but they are not 100% related to those expirations — at least, not directly. Among them:

COVID testing sites are shutting down

Large-scale testing sites have been a crucial part of counties’ ability to slow the spread of COVID over the last few years — and these states of emergency have played a key role in funding these facilities. Now, a large portion of funding for free COVID testing (and vaccination) clinics will come to an end, meaning not only that costs for individuals for these services could rise, but also the sites themselves are starting to shutter. And the sites that remain open will have to look to the future of county-level funding after the state and federal supplies are gone.

But officials say the end of California’s state of emergency is not the sole reason many of these facilities are closing. San Francisco’s free drive-up testing site on Alemany Blvd., for example, is being closed due to a combination of reduced funding and “low demand,” according to San Francisco health officials. Find a COVID testing site near you.

The California Department of Public Health’s post-state of emergency “SMARTER Plan (PDF)” says that as far as schools are concerned, the agency has “completed the distribution of 8.4 million over-the-counter antigen tests for end of school year and summer testing, and an additional 10.6 million for the return from summer break testing.”

California is ending its vaccine mandate for schoolchildren

In 2021, Gov. Newsom announced the policy mandating COVID vaccination for schoolchildren — adding it as one of the (multiple) vaccinations families would need to prove for a child to attend school. There was uncertainty over whether this policy would be extended, and on Feb. 3 the California Department of Health finally announced that the state’s schoolkids would not now have to get a COVID vaccine, and that the department was “not currently exploring emergency rulemaking to add COVID-19 to the list of required school vaccinations,” adding, “but we continue to strongly recommend COVID-19 immunization for students and staff to keep everyone safer in the classroom.”

Because the policy itself originated from the state Department of Public Health, it wasn’t itself affected directly by California’s emergency declaration being lifted. But early this month, just before the change was announced, state public health officials told EdSource in an email that the end of California’s state of emergency was effectively going to end any plan to add COVID vaccinations to the required-vaccines list for schoolchildren.

CalFresh is ending extra payments

During the pandemic, folks using CalFresh — California’s version of the federal Supplemental Nutrition Assistance Program (SNAP) food benefits program for lower-income families — have been receiving extra funds, called “emergency allotments.”

This increase was at least $95 in CalFresh benefits per month. But these extra CalFresh funds will now cease on Feb. 28 — not because they’re tied to California’s state of emergency, but because of the federal Consolidated Appropriations Act of 2023, which ends the pandemic-era release of these extra funds to households across the United States.

Medi-Cal will no longer automatically renew enrollment

When COVID hit, Congress signed a bill that required Medicaid programs around the U.S. — known as Medi-Cal in California — to keep their members continuously enrolled, in exchange for higher federal funding. This has meant that during the pandemic, Medi-Cal has not been permitted to drop people who would otherwise not qualify for the program if they tried to sign up fresh.

But now, the same act that means the end of CalFresh’s extra payments (see above) is bringing an end to the Medi-Cal requirement to automatically renew its members. This means that starting in April, the state will begin to remove folks who no longer qualify — and require Medi-Cal members to manually renew their coverage, which they haven’t had to do for the last few years.

Over 15 million Californians are enrolled in Medi-Cal, and the state forecasts that up to 3 million people could lose their coverage (PDF) if they fail to reenroll or no longer qualify. If you’re on Medi-Cal, the state recommends that you make sure Medi-Cal has your up-to-date contact details, sign up for email and text alerts and watch for the renewal form hitting your mailbox in the coming weeks.

This story has been updated. An earlier version of this story was published on Feb. 15.