The shift will mean an end or change to federally funded tests, vaccinations, and other COVID-19 measures. In addition, the shift will mean a reduction in Medicaid funding, and potential changes to how telehealth is managed. The changes are largely economic, turning pandemic financial support into "regular" healthcare. This means that some Americans, particularly those who are uninsured, will now need to pay out-of-pocket for the protections that have supported a population still facing a COVID-19 death rate that is twice that of the flu.