President Joe Biden administration is expected to renew the Covid-19 public health emergency, ensuring that federal measures expanding access to health coverage, vaccines, and treatments continue beyond the midterm elections, according to three people familiar with the situation. The emergency declaration’s anticipated renewal comes after lengthy discussion among Biden officials, some of whom questioned whether the time had come to let the designation expire.

Key takeaways and importance of the measure are the following:

Lifting the emergency would result in significant policy changes in insurance markets, drug approvals, and telehealth.

It also maintains a higher share of federal Medicaid spending if states provide continuous coverage to enrollees, avoiding the program’s typical churn.

Ending the emergency would involve states to determine whether their Medicaid enrollees are still eligible for coverage, a massive task that could result in the removal of millions of Americans from the program.

The Department of Health and Human Services would extend the proclamation under the planned extension into the November elections and possibly as early as 2023, putting the United States into its fourth calendar year of a Covid public health emergency.

Politico reported, “ In the most recent round of deliberations, some officials have floated allowing the declaration to expire in October, contingent on the administration successfully rolling out its next round of vaccines and averting a fall surge in cases, two people familiar with the matter said. An end of the emergency declaration this year could also provide a pre-election demonstration that the country has, indeed, entered a new phase of the pandemic fight.”

However, such a move would almost certainly be met with fierce opposition from the health industry, as well as criticism from public health organizations on the front lines of efforts to combat the virus and vaccinate more Americans.