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
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