Health Insurance
COVID-19 Public Health Emergency Ends Soon — Here Are the Financial Impacts
After three years of a historic pandemic, the public health emergency (PHE) for COVID-19 is set to expire on May 11, 2023. While this could be seen as a return to normalcy, the end of the PHE will have financial ramifications for those with the virus — particularly those who’re uninsured.
"Since the emergence of COVID-19, the U.S. has treated the disease as a public health emergency," ValuePenguin health insurance expert Divya Sangameshwar says. "That allows the federal government to access funds and resources to pay for tests, vaccines and health insurance for uninsured Americans. When the PHE ends, it’ll have a wide-ranging impact on many aspects of health care that Americans have come to take for granted since COVID-19 reared its ugly head. This includes access to free vaccines, booster shots, tests and treatments, as well as health insurance coverage under Medicaid."
ValuePenguin looked at where COVID-19 treatment costs are highest depending on the treatment type. We also have tips on minimizing treatment costs after the PHE expires.
On this page
- Key findings
- COVID-19 treatments not requiring hospitalization cost more than the average deductible
- Where COVID-19 noncomplex, complex hospitalization costs are highest
- Temporary Medicaid coverage will end in these states with the public health emergency expiration
- Expert tips on receiving COVID-19 treatment after May 11
- Methodology
Key findings
- COVID-19 treatment not requiring hospitalization costs an average of $2,557 — $553 more than the average deductible for single coverage. In 34 states, this type of COVID-19 treatment costs more than the average deductible, meaning those with health insurance would see their coinsurance kick in.
- The average amount charged to a COVID-19 patient admitted to the hospital who doesn’t require ventilation or an intensive care unit (ICU) is $74,591. These costs are highest in California ($111,213), Alaska ($108,870) and Wyoming ($102,772) and lowest in Maryland ($31,339), Michigan ($35,082) and Indiana ($41,064).
- The average amount charged to an admitted COVID-19 patient who requires ventilation or an ICU is $317,810. These charges are highest in Nevada ($472,213), California ($461,780) and Alaska ($417,208) and lowest in Maryland ($131,965), Michigan ($207,926) and Massachusetts ($209,209).
- Uninsured Americans in 18 states who’ve been getting COVID-19 treatment via temporary Medicaid coverage will no longer be covered when the public health emergency ends. The number of enrollees who’ll lose coverage is hard to predict, but the number of Medicaid enrollees spiked by more than 21 million between February 2020 and November 2022.
COVID-19 treatments not requiring hospitalization cost more than the average deductible
The cost of COVID-19 treatment that doesn't require hospitalization is $2,557 on average, $553 higher than the typical deductible for single coverage. In 34 states across the U.S., this kind of treatment — which covers lab testing and doctor or urgent care visits — costs more than the average deductible for single coverage. That means these insured individuals would reach their deductible and coinsurance would come into effect. (Coinsurance is the fixed percentage you pay for medical expenses until you reach your out-of-pocket maximum.)
According to Sangameshwar, the end of the PHE will certainly affect these consumers.
"Americans who get COVID-19 after the PHE ends will be entirely at the mercy of their insurance plans since free tests and treatments will be harder to access," she says. "At the very minimum, they’ll need to pay up to their deductible in health care costs. The insured Americans most financially vulnerable will be the 55.7% of private sector workers enrolled in a high-deductible health plan. For the 64% of Americans living paycheck to paycheck, a $2,577 expense may derail their finances in a substantial way."
Where are these treatment costs highest compared to deductibles? Nevada ranks first, with an average charge for outpatient treatment of $3,725. An average deductible of $1,935 leaves another $1,790 in costs. In other words, treatment costs are 92.5% higher than the average deductible for single coverage. These consumers wouldn’t owe the rest outright because of coinsurance, but they could still be left with a hefty bill depending on the percentage covered after reaching their deductible.
Nevada is followed by:
- The District of Columbia, where the average charge for outpatient COVID-19 treatment is $2,539 and the average deductible is $1,338 (a difference of $1,201, or 89.8%).
- California, where the average charge for outpatient treatment is $3,200 and the average deductible is $1,698 (a difference of $1,502, or 88.5%).
On the other hand, outpatient treatment costs are lowest compared to deductibles in Montana. Here, the average outpatient treatment costs $1,780. An average deductible of $2,409 leaves $629 in deductible expenses. In other words, the average deductible for single coverage is 26.1% higher than treatment costs.
Other states where outpatient treatment costs are lowest compared to deductibles include:
- Maine, where the average charge for outpatient COVID-19 treatment is $1,946 and the average deductible is $2,613 (a difference of $667, or 25.5%).
- Oregon, where the average charge for outpatient treatment is $1,949 and the average deductible is $2,381 (a difference of $432, or 18.1%).
Full rankings
Where COVID-19 treatments not requiring hospitalization cost more than the average deductible for single coverage
Rank | State | Average deductible for single coverage | Average charge for outpatient COVID-19 treatment | $ difference | % difference |
|---|---|---|---|---|---|
| 1 | Nevada | $1,935 | $3,725 | -$1,790 | -92.5% |
| 2 | District of Columbia | $1,338 | $2,539 | -$1,201 | -89.8% |
| 3 | California | $1,698 | $3,200 | -$1,502 | -88.5% |
| 4 | Alaska | $1,746 | $3,200 | -$1,454 | -83.3% |
| 5 | New Jersey | $1,675 | $2,832 | -$1,157 | -69.1% |
| 6 | Hawaii | $1,232 | $2,079 | -$847 | -68.8% |
| 7 | Texas | $2,025 | $3,157 | -$1,132 | -55.9% |
| 8 | Florida | $2,185 | $3,172 | -$987 | -45.2% |
| 9 | Illinois | $1,871 | $2,700 | -$829 | -44.3% |
| 10 | New York | $1,775 | $2,459 | -$684 | -38.5% |
| 11 | Alabama | $1,620 | $2,201 | -$581 | -35.9% |
| 12 | Pennsylvania | $1,863 | $2,472 | -$609 | -32.7% |
Source: ValuePenguin analysis of Fair Health and Kaiser Family Foundation (KFF) data.
Where COVID-19 noncomplex, complex hospitalization costs are highest
What about treatments that require hospitalizations? For those not requiring ventilation or an ICU — referenced as noncomplex — the average charged amount is $74,591, while the median cost is $54,262. (These costs include room and board, lab testing, imaging and IV therapies.)
By average costs, these treatments are highest in California ($111,213), Alaska ($108,870) and Wyoming ($102,772). Meanwhile, they’re lowest in Maryland ($31,339), Michigan ($35,082) and Indiana ($41,064).
States where COVID-19 hospitalizations not requiring ventilation or an ICU cost the most
Rank | State | Median charge | Average charge |
|---|---|---|---|
| 1 | California | $84,006 | $111,213 |
| 2 | Alaska | $83,544 | $108,870 |
| 3 | Wyoming | $78,851 | $102,772 |
| 4 | Nevada | $83,781 | $102,115 |
| 5 | New Mexico | $72,561 | $98,336 |
Source: ValuePenguin analysis of Fair Health data.
For admitted COVID-19 patients who require ventilation or an ICU — referenced as complex — the average cost in the U.S. is $317,810, while the median cost is $208,136. (These costs include ICU and ventilator expenses, as well as room and board that can accommodate complex care.)
By average costs, these charges are highest in Nevada ($472,213), California ($461,780) and Alaska ($417,208). Meanwhile, these charges are lowest in Maryland ($131,965), Michigan ($207,926) and Massachusetts ($209,209).
States where COVID-19 hospitalizations requiring ventilation or an ICU cost the most
Rank | State | Median charge | Average charge |
|---|---|---|---|
| 1 | Nevada | $334,462 | $472,213 |
| 2 | California | $334,011 | $461,780 |
| 3 | Alaska | $342,200 | $417,208 |
| 4 | Texas | $258,305 | $378,052 |
| 5 | New Jersey | $284,143 | $377,198 |
Source: ValuePenguin analysis of Fair Health data.
Full rankings
States where COVID-19 hospitalizations not requiring ventilation or an ICU cost the most
Rank | State | Median charge | Average charge |
|---|---|---|---|
| 1 | California | $84,006 | $111,213 |
| 2 | Alaska | $83,544 | $108,870 |
| 3 | Wyoming | $78,851 | $102,772 |
| 4 | Nevada | $83,781 | $102,115 |
| 5 | New Mexico | $72,561 | $98,336 |
| 6 | Montana | $72,829 | $97,905 |
| 7 | Utah | $71,342 | $96,611 |
| 8 | Arizona | $80,034 | $95,966 |
| 9 | Idaho | $70,321 | $95,584 |
| 10 | New Jersey | $66,034 | $87,301 |
| 11 | Oregon | $69,620 | $82,907 |
| 12 | Washington | $65,187 | $80,336 |
Source: ValuePenguin analysis of Fair Health data.
States where COVID-19 hospitalizations requiring ventilation or an ICU cost the most
Rank | State | Median charge | Average charge |
|---|---|---|---|
| 1 | Nevada | $334,462 | $472,213 |
| 2 | California | $334,011 | $461,780 |
| 3 | Alaska | $342,200 | $417,208 |
| 4 | Texas | $258,305 | $378,052 |
| 5 | New Jersey | $284,143 | $377,198 |
| 6 | Pennsylvania | $245,704 | $373,506 |
| 7 | Oklahoma | $276,375 | $373,128 |
| 8 | Arizona | $291,396 | $361,540 |
| 9 | Florida | $251,240 | $355,450 |
| 10 | Wyoming | $274,330 | $353,623 |
| 11 | Colorado | $270,604 | $350,456 |
| 12 | Washington | $254,390 | $334,224 |
Source: ValuePenguin analysis of Fair Health data.
Temporary Medicaid coverage will end in these states with the public health emergency expiration
While receiving medical treatment can be an unexpected and costly burden on anyone, that’s particularly true for uninsured Americans. During the PHE, 18 states have provided COVID-19 treatment through temporary Medicaid coverage — though these residents will no longer be covered when the public health emergency ends.
Of these states, three are among the 10 states with the highest percentage of uninsured Americans. That includes:
- Nevada: 11.3%
- Arizona: 10.7%
- North Carolina: 10.7%
Here are the rest of the states where this temporary coverage will end (and their uninsured rates):
- South Carolina: 10.5%
- New Mexico: 9.6%
- Utah: 9.0%
- Montana: 8.6%
- Louisiana: 8.3%
- Colorado: 7.9%
- Maine: 7.4%
- California: 7.2%
- Illinois: 7.0%
- Washington: 6.4%
- New Hampshire: 5.9%
- Connecticut: 5.2%
- Iowa: 4.9%
- Minnesota: 4.6%
- Rhode Island: 4.4%
The number of enrollees who’ll lose coverage is hard to predict, but the number of Medicaid enrollees spiked by more than 21 million between February 2020 and November 2022. It’s also worth noting that two of the states where the temporary coverage expansion will end — Utah and Maine — are among the 10 states that have seen the largest jump in enrollees. In Utah, the percentage of Medicaid enrollees jumped by 63.8% between February 2020 and November 2022. In Maine, they jumped by 41.8%.
10 states with the largest jumps in Medicaid enrollees
Rank | State | Medicaid enrollees, February 2020 | Medicaid enrollees, November 2022 | Difference | % difference |
|---|---|---|---|---|---|
| 1 | Oklahoma | 593,369 | 1,150,917 | 557,548 | 94.0% |
| 2 | Missouri | 792,966 | 1,375,480 | 582,514 | 73.5% |
| 3 | Utah | 269,902 | 442,086 | 172,184 | 63.8% |
| 4 | Nebraska | 209,409 | 341,438 | 132,029 | 63.0% |
| 5 | Wyoming | 49,763 | 76,065 | 26,302 | 52.9% |
| 6 | Indiana | 1,218,041 | 1,854,167 | 636,126 | 52.2% |
| 7 | Texas | 3,561,907 | 5,374,020 | 1,812,113 | 50.9% |
| 8 | Hawaii | 299,766 | 431,737 | 131,971 | 44.0% |
| 9 | Virginia | 1,255,472 | 1,789,655 | 534,183 | 42.5% |
| 10 | Maine | 252,974 | 358,750 | 105,776 | 41.8% |
| 10 | North Dakota | 87,760 | 124,446 | 36,686 | 41.8% |
Source: ValuePenguin analysis of Centers for Medicare & Medicaid Services (CMS) data.
Meanwhile, 28.5 million Americans of all ages are uninsured.
Although many uninsured residents getting temporary Medicaid coverage may soon see larger bills for their COVID-19 treatment, it’s worth noting that testing and treatment for Medicaid and Children’s Health Insurance Program (CHIP) patients will be available through September 2024 as part of the American Rescue Plan of 2021.
Full rankings
States with the highest percentage of uninsured Americans
Rank | State | Number of uninsured individuals | % of population |
|---|---|---|---|
| 1 | Texas | 4,995,381 | 17.6% |
| 2 | Oklahoma | 554,123 | 14.3% |
| 3 | Georgia | 1,371,027 | 13.1% |
| 4 | Florida | 2,657,226 | 12.6% |
| 5 | Alaska | 86,440 | 12.2% |
| 6 | Mississippi | 350,775 | 12.1% |
| 7 | Wyoming | 66,211 | 11.7% |
| 8 | Nevada | 340,894 | 11.3% |
| 9 | North Carolina | 1,092,162 | 10.7% |
| 9 | Arizona | 743,344 | 10.7% |
| 11 | South Carolina | 521,410 | 10.5% |
| 12 | Idaho | 182,072 | 10.2% |
Source: ValuePenguin analysis of U.S Census Bureau 2021 American Community Survey (with five-year estimates) data.
States with the largest jumps in Medicaid enrollees
Rank | State | Medicaid enrollees, February 2020 | Medicaid enrollees, November 2022 | Difference | % difference |
|---|---|---|---|---|---|
| 1 | Oklahoma | 593,369 | 1,150,917 | 557,548 | 94.0% |
| 2 | Missouri | 792,966 | 1,375,480 | 582,514 | 73.5% |
| 3 | Utah | 269,902 | 442,086 | 172,184 | 63.8% |
| 4 | Nebraska | 209,409 | 341,438 | 132,029 | 63.0% |
| 5 | Wyoming | 49,763 | 76,065 | 26,302 | 52.9% |
| 6 | Indiana | 1,218,041 | 1,854,167 | 636,126 | 52.2% |
| 7 | Texas | 3,561,907 | 5,374,020 | 1,812,113 | 50.9% |
| 8 | Hawaii | 299,766 | 431,737 | 131,971 | 44.0% |
| 9 | Virginia | 1,255,472 | 1,789,655 | 534,183 | 42.5% |
| 10 | Maine | 252,974 | 358,750 | 105,776 | 41.8% |
| 10 | North Dakota | 87,760 | 124,446 | 36,686 | 41.8% |
| 12 | Florida | 3,359,727 | 4,752,201 | 1,392,474 | 41.4% |
Source: ValuePenguin analysis of Centers for Medicare & Medicaid Services (CMS) data.
Expert tips on receiving COVID-19 treatment after May 11
While most consumers with private health insurance won’t see any changes in COVID-19 vaccine and treatment costs, those relying on temporarily expanded Medicaid will. With the PHE coming to an end, there are a few things these consumers should do to ensure they won’t have to pay massive out-of-pocket fees if they get sick with COVID-19. Particularly, Sangameshwar recommends:
- Get vaccinated and boosted ASAP. "Uninsured Americans who haven’t gotten vaccinated shouldn’t delay anymore," she says. "While vaccination will remain free after the COVID-19 PHE ends, the free vaccines will stop when the government-subsidized supplies run out. COVID-19 vaccines remain the best defense against serious COVID-19 infection, so getting vaccinated and boosted while supplies are available will keep uninsured Americans safe."
- Get insured ASAP. "Americans who may lose their Medicaid or CHIP should not wait to seek health coverage," she says. "Since losing health care is a special qualifying event, they can get a subsidized private health insurance plan to provide them with some level of coverage. They should also start looking into re-enrolling in Medicaid if they’re eligible to minimize the window in which they’re uninsured."
- Look for community health centers. "Community health centers and free clinics often take uninsured patients and will not charge them massive out-of-pocket costs for treatment," she says. "While uninsured Americans will still need to pay out of pocket for COVID-19 testing and treatment, these clinics substantially subsidize the cost of treatment and testing, making it a little more manageable financially."
Methodology
ValuePenguin researchers analyzed Fair Health data on charge amounts for uninsured or out-of-network patients for various COVID-19 treatment protocols:
- Complex inpatient: Costs for COVID-19 treatment for an admitted patient who requires ventilation or an ICU. This includes — among other things — ICU and ventilator costs, as well as room and board.
- Noncomplex inpatient: Costs for COVID-19 treatment for an admitted patient who doesn’t require ventilation or an ICU. This includes — among other things — room and board, testing, imaging and IVs.
- Outpatient: Costs for COVID-19 treatment that doesn’t require hospitalization. This includes — among other things — laboratory testing and doctor or urgent care visits.
Researchers used:
- Kaiser Family Foundation (KFF) data for the average annual deductible for single coverage in 2021
- Centers for Medicare & Medicaid Services (CMS) data for Medicaid enrollment in February 2020 and November 2022
- U.S. Census Bureau 2021 American Community Survey (with five-year estimates) data for the number and percentage of uninsured Americans