“The sky is falling! The sky is falling!” That’s the familiar refrain of Chicken Little in the fable about coming disaster. To hear the Biden administration, and its surrogates like the American Hospital Association, disaster is looming on the healthcare horizon.

What am I talking about? The Covid Public Health Emergency declaration is finally coming to an end in May and those who have benefited from it are up in arms. Make no mistake about it, this is a long overdue day of reckoning for Medicaid and those who have greatly benefited from the declared emergency situation.

Stephanie Armour, reporter for The Wall Street Journal, says, “An unprecedented effort by states to review the eligibility of more than 90 million people on Medicaid carried high financial stakes for industry groups, including hospitals that risk paying more to cover uninsured patients and insurers that could lose some of the money they get for managing state Medicaid programs.”

She notes that eligibility reviews for people who get Medicaid coverage were paused during the Covid-19 pandemic. The resumption of those reviews and disenrollment of people, technically starting Saturday, April 1, has industry working with federal regulators, patient advocacy groups and state Medicaid offices to urgently inform beneficiaries. All of them are working to tell enrollees what steps they can take to avoid losing coverage or how to secure other types of health insurance if they earn too much for the program.

To read her report, and the responses of the hospital industry, you would surely believe the “sky is falling.” But what is really happening here?

Ten months ago, on June 20, 2022, I published a blog entitled Medicaid Sick with Long Covid. The article highlighted the extreme cost of Medicaid coverage as a direct result of extending the Covid pandemic declared emergency. As a condition to receive extra money from the federal government to cover Medicaid expenses, they are not permitted to disenroll Medicaid beneficiaries who would otherwise be ineligible. In other words, no matter how much their financial situation improves, they must still receive Medicaid benefits.

At that time, a study by the Foundation for Government Accountability (FGA) estimated 98 million Medicaid enrollees, including as many as 23 million people no longer eligible (by normal Medicaid eligibility standards.) That’s nearly one in three Americans receiving Medicaid benefits!

I said at the time: “Medicaid is supposed to be a healthcare system for low-income Americans who cannot afford their own private insurance. The enrollment of Medicaid has skyrocketed ever since ObamaCare was instituted in 2014 when eligibility criteria were expanded. Now, with this Covid Public Health Emergency declaration, the rolls of Medicaid continue to escalate, regardless of financial prosperity. This is clearly just another way the left wants to bring more and more Americans under the umbrella of government-controlled healthcare. It’s a back-door to socialized medicine. This is just another example of a government handout that was intended to be temporary, but now the Democrats want to make permanent. (see Making ObamaCare Temporary Subsidies Permanent)  

What is the cost of this expanded Medicaid to the taxpayers?

My response then was, “By October, 2022, “ineligible enrollees will cost taxpayers nearly $16 billion per month,” the FGA predicts, “with states picking up nearly $6 billion of those costs when the public health emergency ends.” State officials would be wise to think through what to do next, and remember that every dollar spent on an ineligible Medicaid beneficiary is a dollar that’s not spent on other priorities, including those who need help the most.” This high additional burden on taxpayers has now continued nearly another year.

The hospital industry and these otherwise ineligible Medicaid enrollees are the ones who have reaped the greatest benefit from this government largesse. Now we are supposed to feel sorry when this government handout is taken away? Regardless of what the hospital industry spokesmen say about the state of the hospital industry, in my town all the hospitals are expanding in a wave of building campaigns that tell the real story of their financial situation.

Ms. Armour’s report verifies my impressions. She says, “The pandemic and pause on disenrollments meant robust growth for the five national companies with the largest Medicaid managed care business. Enrollment grew by 38.3% to 41.6 million, from 3/31/20 to 6/30/2022, according to a report last year by the Georgetown University Health Policy Institute. For the three companies for which information is available – Centene Corp., Molina Healthcare, Inc., and UnitedHealth Group Inc., Medicaid revenues increased by 40%, from $31.8 billion to $44.4 billion over that time.”

It’s about time that those whose who have achieved improved financial status stop abusing taxpayers by continuing to claim financial hardship and those hospitals who have made enormous profits from this situation stop pretending the sky is falling.

When I started medical school nearly fifty years ago in 1975, natural immunity was a well-recognized concept. It was not controversial; it was proven scientific fact.

For reasons that remain obscure, the scientific community was slow to acknowledge this fact in the wake of the Covid pandemic. For nearly three years, public-health officials dismissed the same understanding in their efforts to promote new vaccines for everyone, whether you had already had Covid or not. It seemed that politics was overwhelming scientific knowledge, regardless of how many times we heard, “we only follow the science.”

Much of the opposition to natural immunity was associated with those who pushed for lockdowns. The scientific community pushed back in the Great Barrington Declaration (GBD), which was written by three world-renowned epidemiologists and immunologists from Stanford, Harvard, and Oxford. In autumn 2020. Over 936,000 epidemiologists and physicians have signed this document, acknowledging the effectiveness of natural immunity.

Finally, albeit much too late, this is changing. The Lancet medical journal this month published a review of 65 studies that concluded prior infection with Covid – i.e. natural immunity – is at least as protective as two doses of mRNA vaccines. Allysia Finley, writing for The Wall Street Journal, says the only thing surprising about that was that the study made the mainstream press.

“Immunity acquired from a Covid infection is as protective as vaccination against severe illness and death, study finds,” NBC reported on February 16. The study found that prior infection offered 78.6% protection against reinfection from the original Wuhan, Alpha or Delta variants at 40 weeks, which slipped to 36.1% against Omicron variant. Protection against severe illness remained around 90% across all variants after 40 weeks. These results exceed what other studies have found for two and even three mRNA doses.

This news wasn’t fit to print until experts at the University of Washington confirmed it in a leading – and left-leaning – journal. The Lancet has a storied history of controversial publications including the debunked theory that measles vaccine causes autism.

Finley says The Lancet study’s vindication of natural immunity fits a pandemic pattern. The public-health clerisy rejects an argument that ostensibly threatens its authority; eventually it’s forced to soften its position in the face of incontrovertible evidence; and yet not once does it acknowledge its opponents were right in the first place.  The supposition that prior Covid infection could protect against future illness was deeply rooted in immunology before studies bore it out. Those who dismissed natural immunity argued it wasn’t known how long protection against reinfection would last. That’s true, but we still don’t know exactly, and it seems to vary by person and variant. This is no surprise since we all have our own different levels of immunological competence.

The fact is that all of us are exposed to viruses and bacteria every day. Over their lifetimes people are frequently reinfected with viruses that cause respiratory illnesses, including other coronaviruses (like the common cold). But healthy people rarely get severely ill with a virus to which they’ve already been exposed. Infections generate antibodies in our blood and the membranes of the upper respiratory tract that prevent reinfection in the short-term. They also generate and train B and T white blood cells that prevent serious illness after antibodies wane (known as cellular immunity).

Repeat exposures train our immune systems to live with and fight off viruses as they become endemic in a sort of “peaceful coexistence.” Covid is moving from a pandemic to an endemic, much like influenza, and we will learn to live with it just as we have influenza. The GBD called for a new pandemic strategy with a focus on protecting the elderly and vulnerable while letting those at low risk for severe illness “live their lives normally to build up immunity to the virus through natural infection.” The aim was to minimize deaths and social harm until we reached herd immunity. While the goal of herd immunity proved elusive as the virus mutated, the declaration’s central premise was always correct: “As immunity builds in the population, the risk of infection to all – including the vulnerable – falls.” This is precisely what has happened over the past three years. Vaccines helped mitigate severe illness while people developed stronger natural immunity.

What about the future?

Although the virus has become more transmissible, we’ve built up what experts call an “immunity wall” that prevents it from spreading like a wildfire through a dense, dry forest, as happened in China after Beijing lifted its zero-Covid policy.  The public-health clerisy worried that acknowledging natural immunity would encourage people to get infected or discourage them from getting vaccines. The first concern was unsupported, and the second was no reason to deny scientific reality. Public-health officials in the U.S. nonetheless dug in and refused to provide exemptions from vaccine mandates for those with natural immunity, as many European countries did. This has undermined the credibility of these public-health officials, which may prove harmful in the event of future pandemics.

To add insult to injury, tech companies suppressed discussion of natural immunity. Twitter flagged posts that claimed natural immunity was superior to vaccines as “misleading.” Facebook misinformation policy still restricts distribution of content that “implicitly discourages vaccination by advocating for alternatives” such as “natural immunity.” Amazon refused to publish books that didn’t agree with the decisions of the public-health officials.

Finley concludes, “The Lancet study could serve a useful political purpose by giving public-health officials cover to relax vaccine mandates, which in turn could reduce resistance to vaccines. But this would require the clerisy to concede its opponents were right.” Don’t hold your breath waiting for that to happen!