Healthcare policy predictions for 2021


As the days tick down to the inauguration of President-elect Joseph Biden and Vice President-elect Kamala Harris, what will be the priorities of the new administration when it comes to U.S. healthcare? Let’s take a look.

Handling the COVID-19 pandemic

Obviously, the largest challenge is the COVID-19 pandemic. Vaccines from Pfizer and Moderna are slowly being administered in most states. The priority is vaccinating healthcare frontline workers and then the vulnerable elderly, but experts say the decentralized nature of the distribution plan has slowed the rollout. Biden and Harris revealed their plan for addressing the pandemic during their campaign. The plan includes mask mandates and expanded testing, and increased production of PPE.

The Affordable Care Act

Biden and Harris made the Affordable Care Act (ACA) a primary platform in their campaign. Among the elements of this platform are to offer a public health insurance option like Medicare; increase the value of tax credits to lower premiums and extend coverage; expand coverage to low-income Americans by offering the public health insurance option without premiums; stop surprise billing; tackle market concentrations across the health care system; and lower costs and improve health outcomes by partnerships with the healthcare workforce.

Collaboration on addressing social determinants of health

In November 2020, NASDOH, the National Alliance to Impact the Social Determinants of Health, issued a white paper about working with the Biden administration to improve health equity and address SDOH. NASDOH stated that “Improving America’s health requires us to address the effective coordination and allocation and investment of federal resources to impact SDOH,” Furthermore, the COVID-19 pandemic has highlighted the cost of inaction on SDOH, shown by the disparities in pandemic outcomes across different communities.

Possibilities with a Senate majority

The successful capture of both of Georgia’s Senate seats in the January 6 runoff gives the Democrats control of Congress, and gives Biden the ability to make substantial changes to healthcare, as Healthcare Finance writes. Expect strengthening and tweaking of the ACA, more incentives to states to expand Medicaid coverage, and drug price negotiation.

What probably won’t be part of a Democratic health care bill is the public health care option, according to Vox, which believes the legislative difficulties in trying to pass this measure with a narrow majority of the Senate may be too difficult to overcome. Unless Democrats are willing to eliminate the 60-vote legislative filibuster, they’ll have to use budget reconciliation, a special procedural tool, in order to pass the bill with just 51 votes. They report that “Budget reconciliation comes with limits on what provisions can be included, narrowly targeted to federal spending, and the public option may not qualify.”

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