The Trump administration, eager to claim victory over the coronavirus, has been considering reducing the declared national emergency earlier this year to control the pandemic, according to health industry officials who have spoken to the administration.
The prospect has raised alarm among public health leaders, doctors, hospital officials and others who are trying to control the outbreak and fear that such a move will make it harder for state and local governments and health systems to maintain control of the coronavirus.
Pressed on the issue Tuesday, White House press secretary Kayleigh McEnany told the Los Angeles Times that such a move was not imminent.
“I just spoke to the president,” he said, “and he said that we are not seeking to lift national emergency declarations.”
But White House officials have a history of contradictions, most recently on Monday when McEnany claimed that President Trump was joking over the weekend when he said he had ordered aides to stop testing for coronavirus. Trump said Tuesday it was not a joke.
Several industry officials interviewed by The Times said they had received indications during the last week from the Trump administration that it was considering lifting the emergency declarations.
“It was hotly debated,” said an industry official, who asked not to be named to avoid jeopardizing relations with the administration.
Discussions have taken place as hospitalizations and the number of cases began to increase rapidly in several large states that came forward to lift restrictions on companies, an increase that could make it difficult for the administration to finalize emergency declarations.
Health care leaders said they were baffled by the administration’s unwillingness to publicly commit to an extension of the emergency declarations, one of which is slated to expire next month.
“It is silence that concerns us,” said Meg Murray, executive director of the Association. for Community Affiliated Plans, which represents nonprofit health insurers, many of whose clients are overwhelmingly low-income. “If they saw the world as we are, we would expect them to be clearer.”
“I know the administration is trying to pretend this is over, but clearly it is not,” said Dr. Georges Benjamin, the head of the American Public Health Association. “Many governors are still struggling to figure out what they need to do, particularly in those states where they are beginning to realize they have emergencies. … We need the flexibility that emergency declarations provide. “
Emergency declarations that the administration has issued since the start of the year have loosened or waived rules and regulations on hospitals and other medical providers and have helped route the much-needed states money.
A dramatic expansion in telemedicine, for example, has been tempered by an emergency declaration allowing Medicare and commercial health plans to reimburse clinics and hospitals for phone and internet visits. That made it possible for patients to see their doctors without having to go to an office.
Similarly, hospitals have been able to quickly recruit more staff, sometimes from other states, and add beds without going through a lengthy permitting process.
Emergency declarations have also freed up additional Medicaid money for states and made it easier to ensure that people who depend on Medicaid don’t lose coverage during the economic downturn.
California received a waiver from the federal government to allow patients in its Medicaid program to receive mental health and substance abuse treatment more quickly through telemedicine.
“People may not be aware of how important these statements are to the ability of the health care system to address the coronavirus,” said Carmela Coyle, president of the California Hospital Association, many of whose members have been struggling to control the California outbreak.
California is among more than two dozen states where the number of coronavirus cases is increasing, according to data compiled by the Coronavirus Resource Center at Johns Hopkins University.
The increases in some states may largely reflect more evidence, which health officials say they believe is the case in California. Many states, including Texas and Florida, are also seeing a sharp increase in hospitalizations, indicating that serious cases are on the rise.
Now, public health experts fear that deaths will soon begin to rise again after a months-long decline. COVID-19, the disease caused by the virus, has killed more than 120,000 Americans.
Despite troubling figures, Trump has been downplaying the threat for weeks as the cost of the economic slowdown has become increasingly acute.
The president drastically reduced the working hours of the White House coronavirus task force and ended the group’s daily briefings, including its top scientists. He has called for a rapid return to normality, celebrating state movements to relax restrictions.
Trump also goes on to argue that the increasing number of cases is entirely due to more evidence, an idea widely rejected by public health experts.
Declaring the end of the national emergency may reinforce the president’s assertion that the country is returning to normal.
One of the statements, a public health emergency issued by the Department of Health and Human Services in January and renewed in April, will expire in late July unless renewed by the agency.
A spokesperson for the health agency did not discuss the statement in the registry, but in a statement said: “At this time, HHS expects to renew the Public Health Emergency due to COVID-19 before it expires. We have already renewed this PHE once. “
The hospital, health plan, and public health officials say the renovation is important. But they caution that it is equally important to ensure that the president does not complete the related national emergency declarations he made in March.
These additional statements, a so-called national emergency declaration and another so-called Stafford Act declaration, are also critical to sustaining the health system’s response, they say.
“Key exemptions and increased access to many critical supplies depend on these statements being in effect,” said Chip Kahn, head of the Federation of American Hospitals. “It is unfathomable to me that they would drop any one of them.”
Trump was reluctant to issue additional national emergency declarations in March, as he worked at the time to minimize the severity of the coronavirus outbreak.
The delay prevented states from taking full advantage of their Medicaid programs, fueling mounting cries from state leaders for White House action.
Times editor Eli Stokols contributed to this report from Washington.
