Timeline of End Dates for Key Health-Related Flexibilities Provided Through COVID-19 Emergency Declarations, Legislation, and Administrative Actions

In response to the unprecedented nature of COVID-19, the federal government declared numerous types of emergencies, Congress enacted several pieces of legislation, and various executive actions were taken and waivers issued, which, collectively, established time-limited flexibilities and provisions designed to protect individuals and the health system during the pandemic. The effective end dates of many, though not all, of these flexibilities and provisions are tied to the public health emergency (PHE) declaration made pursuant to Section 319 of the Public Health Service Act, first declared in January of 2020.  Others are linked to the public health emergency declaration made under Section 564 of the Federal Food, Drug and Cosmetic (FD&C) Act; the declaration made under the Public Readiness and Emergency Preparedness (PREP) Act; and emergency and major disaster declarations made under the Stafford Act. In some cases, subsequent legislation has either delinked provisions from these declarations or otherwise changed their duration.

The Biden Administration recently announced that it will end the PHE on May 11, 2023 and FEMA has announced that the emergency incident period under the Stafford Act will also end on that date. Other related emergency declarations or provisions have already ended or are ending soon. The following table (Table 1) provides a timeline identifying key health-related flexibilities and provisions specified by these various measures, the specific measure that determines their end date, and their end date (an end date for the Section 564 declaration has not yet been announced).

In addition to the end of the flexibilities detailed in Table 1 below, there are also expectations that the federal supply of COVID-19 vaccines could be depleted or need to be replaced by an updated booster dose sometime this year and, similarly, the federal supply of COVID-19 treatments will also be depleted. At a result, COVID-19 vaccines and treatments are transitioning to the commercial market. Importantly, this change is not tied to the end of the public health emergency.

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