Enough with the backdoor policymaking. It's time to end the COVID public health emergency.

In July, the Biden administration extended the COVID-19 public health emergency into October, and he appears poised to extend it again for at least another three months.

At this point, nearly all Americans have some form of immunity. Hospitalization rates haven't been high for months (despite case rates remaining high in much of the country).

A poll conducted this spring by the Pew Research Center showed the pandemic ranks 12th out of 12 top concerns that Americans are worried about.

So was it necessary to extend the public health emergency this summer? We think not. Also, keeping the emergency in place now, when we no longer need it, could undermine public buy-in for future health emergency declarations when they are needed.

Here are some of the policies that the public health emergency allows:

►The administration can maintain expanded benefits for people enrolled in Medicare and Medicaid.

►All states and Washington, D.C., can offer expanded telehealth services without getting prior authorization from the federal government.

►Hospitals receive a 20% increase in the Medicare payment rate for every patient diagnosed with COVID.

This bolus of payments might help explain why all the large urban hospital systems we checked and the vast majority of smaller systems were still COVID testing all patients. The tests themselves can also be cash generators for hospitals.

Lining up for COVID-19 tests in 2021 at the University of California, Berkeley.
Lining up for COVID-19 tests in 2021 at the University of California, Berkeley.

Unsurprisingly, the American Hospital Association – a powerful lobbying presence in Washington whose strength has been magnified by the pandemic – sent a letter in March to the head of the Health and Human Services Department petitioning for the extension of the public health emergency.

Some of these expanded benefits are not necessarily bad. More available telehealth can help many vulnerable and isolated Americans. And without the public health emergency, millions may be kicked off of Medicaid due to tightening of eligibility standards.

But if the administration wants to keep these benefits in place, it needs to follow the normal democratic and legislative processes to do so, instead of using the emergency to duck the need for congressional approval. For example, some Republican lawmakers cried foul when the COVID-19 state of emergency provided the basis for President Joe Biden to grant debt relief for unpaid college loans through the post-9/11 Heroes Act.

Regardless of whether the order was technically legal, public health emergencies should be reserved for combating actual threats, not used as a backdoor to health care (or economic) reform.

COVID-19 vaccination clinic in 2021 in Springfield, Mo.
COVID-19 vaccination clinic in 2021 in Springfield, Mo.

Drawbacks of letting COVID-19 emergency drag on

There are serious downsides to keeping a health emergency order in place for years:

►Continuing to funnel billions of dollars solely to combat COVID-19 means other potential health emergencies may get short shrift. Monkeypox cases are a significant issue, and the polio virus was recently detected in New York City's wastewater, so we need to allocate resources sooner rather than later to increase vaccine stocks, conduct research and testing, and perform outreach to affected communities.

►The 20% bonus payment to hospitals for treating COVID-19 patients is meant to offset costs of protocols that limit the spread of the disease, but testing everyone also means that hospitals are full of people who are there for non-COVID reasons but cannot be discharged to rehab or skilled nursing facilities because of their positive test. The focus should be on protecting people in hospitals who are truly vulnerable to a severe COVID outcome.

►Keeping the country under a state of emergency might be emboldening state and local governments to hang on to pointless but harmful COVID-19 restrictions. Despite the Centers for Disease Control and Prevention's relaxing of recommendations for schools, a school in Albuquerque, New Mexico, recently went remote because its COVID plan, devised last year, requires closing if 3% of staff and students test positive.

Lifting the federal public health emergency will free up funds and hospital capacity, discourage policymakers from clinging to harmful pandemic policies and help guide the country back toward much-needed normalcy.

Margery Smelkinson, Ph.D., is an infectious disease scientist whose research has focused on influenza and the COVID-19 disease. Leslie Bienen, DVM, is a veterinarian and professor of public health at the OHSU-Portland State University School of Public Health.

This article originally appeared on USA TODAY: COVID public health emergency extension undermines future pandemics