What will change once federal COVID-19 emergency ends in May?

The declaration of a national COVID-19 public health emergency three years ago changed lives by offering Americans increased health care coverage, beefed-up food assistance and universal access to coronavirus vaccines and tests.

Much of that is now coming to an end, with President Joe Biden planning to end the emergency declarations on May 11.

Here’s a look at what will stay and what will go once the emergency order is lifted:

TESTS, TREATMENTS, VACCINES

The at-home nasal swabs, COVID vaccines and boosters, treatments and other products that scientists developed the past three years will still be authorized for emergency use by the federal Food and Drug Administration once the public health emergency is over.

But how much people pay for certain COVID-related products could change.

Insurers, for instance, no longer will be required to cover the cost of providing free at-home COVID tests.

The Biden administration has said it is running out of money to buy vaccines, and Congress hasn’t budged on the president’s requests for more funding.

Many states expect they can make it through the spring and summer, but there are questions about what their vaccine supply will be come fall — when respiratory illness typically start to rise.

MEDICAID

Medicaid enrollment ballooned during the pandemic in part because the federal government barred states from removing people from the program during the public health emergency once they were enrolled.

The program offers health care coverage to roughly 90 million children and adults — one of every four Americans.

Late last year, Congress said states could start removing ineligible people in April. Millions are expected to lose their coverage because they now make too much money to qualify for Medicare or because they’ve moved, though many are expected to be eligible for low-cost insurance plans through the Affordable Care Act’s private marketplace or their employer.

STUDENT LOANS

Payments toward federal student loans were halted in March 2020 under the Trump administration and have been on hold since. The Biden administration announced a plan to forgive up to $10,000 in federal student loan debts for individuals with incomes under than $125,000 or households with incomes under $250,000.

But that forgiveness plan — which more than 26 million people have applied for — is on pause, in a legal limbo while awaiting a ruling from the Supreme Court.

The pause on student loan payments is expected to end 60 days after the Supreme Court rules.

IMMIGRATION AT MEXICO BORDER

Border officials still will be able to deny people the right to seek asylum, a rule that was introduced in March 2020.

Those restrictions remain in place at the U.S.-Mexico border pending a Supreme Court review, regardless of the COVID emergency’s expiration. Republican lawmakers sued after the Biden administration moved last year to end the restrictions, known as Title 42. The Supreme Court kept the restrictions in place in December until it can weigh the arguments.

The end of the emergency could bolster the legal argument that Title 42 restrictions no longer should remain in place. The restrictions fell under health regulations and have been criticized as a way to keep migrants from coming to the border, rather than to stop the virus’ spread.

TELEHEALTH

COVID accelerated the use of telehealth, with many providers and hospital systems shifting delivery of care to a smartphone or computer format.

The emergency declaration hastened that approach by suspending some of the rules that previously governed telehealth and allowed doctors to bill Medicare for care delivered virtually, encouraging hospitals to invest more in telehealth systems.

Congress is extending many of those telehealth flexibilities for Medicare through the end of next year.

FOOD ASSISTANCE

Relaxed rules during the health emergency made it easier to receive a boost in benefits under the federal Supplemental Nutrition Assistance Program, known as SNAP. State and congressional action has started to wind down some of that. Emergency allotments — typically about $82 a month — will come to an end as soon as March in more than two dozen states.

Food help for unemployed adults under age 50 and without children will also change after the health emergency is lifted in May. During the declaration, a rule that required those individuals to work or do job training for 20 hours a week to remain eligible for SNAP was suspended. That rule will be in place again starting in June. SNAP aid for more low-income college students also will draw down in June.

MONEY FOR HOSPITALS

When the emergency order ends, hospitals no longer will get an extra 20% for treating COVID patients who are on Medicare. That will come at a time many hospitals are under financial pressure, struggling with worker shortages and inflation, said Stacey Hughes, executive vice president of the American Hospitals Association.