Biden’s Shopping List of Administrative Health Actions

Joe Biden is set to take office tomorrow. His incoming administration faces enormous challenges to help get the country back on something resembling a normal footing. Nowhere is this truer than in health care.

Immediate attention will and should be focused on his plans to greatly expand support for COVID-19 care, testing, and vaccinations. The challenge here will be to secure quick Congressional action on his broader, $1.9 trillion package to send more money to consumers, speed the reopening of in-person K-12 schooling, and help people get back to work.

There is overwhelming support for the COVID portions of this package but enough opposition to the entire measure to threaten quick approval by our bitterly divided houses of Congress. Toss in a second impeachment trial of our soon-to-be former president, and damaging delays become that much more likely, even if House Speaker Nancy Pelosi creates breathing room to consider Biden’s plan by deferring delivery of her chamber’s articles of impeachment to the Senate.

Broader changes in health care are also on the agenda. Attention has been directed at expanding Medicare to younger ages and also responding to the continuing wish from progressive Democrats for a new single-payer system that would provide cheaper health insurance to every citizen, largely at the expense of private insurance and health care companies. Few people expect such changes to become law anytime soon.

Because Congress is so sharply divided, the most imminent health care changes are those that the incoming president has the power to implement without Congressional approval. The Kaiser Family Foundation has worked up a useful list of such administrative items. The summary list below includes short-hand references that are fully explained in the Kaiser review.

 

COVID-19

Renew Declaration that COVID-19 is a National Emergency

Renew Declaration that COVID-19 is a Public Health Emergency

Restore U.S. Membership in the World Health Organization

Join COVAX

Restore Directorate for Global Health Security and Biodefense

Convene Daily White House COVID-19 briefings

Launch National COVID-19 Vaccine Campaign

Establish Pandemic Testing Board

Issue Strong National Social Distancing Guidance to States and Localities

Expand Use of the Defense Production Act (DPA)

Establish COVID-19 Racial and Ethnic Disparities Task Force

Create National COVID-19 Data Dashboard

Review Entry and Detention policies based on public health criteria

 

AFFORDABLE CARE ACT

Restore federal spending on navigators and on marketing and outreach and restore navigator standards

Ensure availability of healthcare.gov and strengthen standards for web brokers and brokers selling marketplace plans

Reverse guidance for Section 1332 state waivers

Increase Marketplace enrollment by extending open and special enrollment opportunities

Restore federal marketplace user fees

Increase Marketplace subsidies

Reverse expansion of short-term health insurance

Reverse association health plan regulation

Strengthen Essential Health Benefits

 

MEDICAID

Revise Section 1115 state demonstration waiver policy to focus on increasing and expanding coverage

Ensure eligible people can enroll in and maintain Medicaid coverage

Reinstate beneficiary protections and provide certainty on state financing mechanisms

Maintain Medicaid coverage and beneficiary protections

Expand support for states to respond to COVID-19 pandemic

Strengthen and expand long-term care services and supports

 

WOMEN’S HEALTH POLICY

Restore Title X Family Planning Program regulations to require pregnancy options counseling to include abortion and allow clinics to provide abortions with non-federal funds

Prohibit state Title X grantees from banning family planning providers that also provide abortions from participating in the program

Simplify payment for abortion coverage in Marketplace plans

Revise ACA contraceptive coverage regulations to guarantee coverage for more women

Restore guidance to affirm the Medicaid “free choice of provider” provision

Rescind Mexico City Policy

Affirm reproductive health rights, including abortion, globally

Allow NIH funding of research involving fetal tissue

Restore ACA non-discrimination regulations to protect patients who have had an abortion or are seeking an abortion

Reverse policies that promote and expand religious conscience protections for medical providers over civil rights

Improve health care access for incarcerated women

Protect and prioritize survivors of sexual assault

 

MENTAL HEALTH AND SUBSTANCE USE

Improve mental health services for veterans

Address suicide among LGBTQ youth

Increase school-based mental health services

Enforce Mental Health Parity

Fight the Opioid Crisis

 

IMMIGRATION AND HEALTH

Reinstate Deferred Action for Childhood Arrivals (DACA) program and review Temporary Protected Status (TPS) designations

Reverse policies that limited pathways to lawfully enter the United States

Reprioritize enforcement policies to protect immigrant families and children

Revise policies on immigrant detention for families

Reverse changes to public charge policies

 

LONG-TERM CARE

Restore mandatory penalties for nursing facility violations of federal requirements when residents were in “immediate jeopardy” but did not suffer harm

Revise recent or pending nursing home regulations to restore resident protections and strengthen oversight

Improve nursing home staffing and oversight

Support nursing homes’ response to COVID-19 pandemic

Advance policies that strengthen home and community-based services

 

HIV/AIDS POLICY

Reinstate White House Office of National AIDS Policy

Release a new comprehensive National HIV/AIDS Strategy

Revise regulation implementing Section 1557 of the ACA

Reverse expansion of short-term limited duration (STLD) plans, non-ACA compliant plans

Update FDA blood donation policy

Rescind “Deploy or Get Out” Policy

Rescind Mexico City Policy

 

LGBT HEALTH

Revise regulation implementing Section 1557 of the ACA

Reverse policies that promote and expand religious conscience protections for medical providers over civil rights

Expand data collection related to gender identity and sexual orientation

 

Find details about how you can reform your own health care right now, in my new book, Get What’s Yours for Health Care: How to Get the Best Care at the Right Price.