Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Biden Sworn In as 46th President of the United States

Joe Biden and Kamala Harris were sworn in as the nation’s President and Vice President during a scaled-back inauguration ceremony last week. Approximately 25,000 National Guard soldiers had been deployed throughout the Washington, D.C. area in anticipation of the event, which came two weeks after the insurrection at the Capitol by Trump supporters. In place of a large crowd, nearly 200,000 American flags were planted on the National Mall to honor the victims of the COVID-19 pandemic. President Donald Trump opted not to attend the inauguration and instead departed the White House early Wednesday morning for his Mar-a-Lago estate in Palm Beach, Florida. Vice President Pence and former presidents Bill Clinton, George W. Bush, and Barack Obama attended the inauguration. The 46th President’s inaugural remarks focused on the need for unity to confront the pandemic and the nation’s current social and economic challenges. The new President and Vice President then visited Arlington National Cemetery in place of the traditional inaugural parade.

Democratic senators Jon Ossoff and Raphael Warnock, elected in Georgia’s run-off elections earlier this month, and Alex Padilla, Harris’ replacement in the Senate, were sworn in shortly after Biden and Harris took office. Their presence officially gives Democrats control of the Senate with 50 seats, leaving Vice President Harris to cast any tie-breaking votes.

Bidenís First Days in Office Include Health-Related Executive Actions, Regulatory Freeze

President Joe Biden took more than a dozen executive actions during his first days in office, many aimed at supporting the economy and containing the coronavirus pandemic. The President also unveiled a national strategy to curtail the coronavirus pandemic. The National Strategy for the COVID-19 Response and Pandemic Preparedness includes a series of executive actions to overhaul the federal government’s response to the coronavirus. The strategy is based on seven goals, including restoring trust with the American people; mounting a safe and effective vaccination campaign; expanding masking, testing, data and treatments; building the health care workforce; safely reopening schools, businesses and travel while protecting workers; protecting those most at risk for serious illness, including people of color; and restoring U.S. leadership globally. Many of the President’s proposals require new funding that would be included in his American Rescue Plan. The 200 page blueprint includes:

  • An executive order (E.O.) to expand use of the Defense Production Act (DPA) to produce more medical supplies needed to fight the virus. The administration has identified 12 immediate supply shortages that could be improved through the use of the DPA.
  • A Presidential Memorandum directing increased reimbursement for states that have deployed National Guard to assist with their pandemic response for personnel costs and emergency supplies.
  • An executive order (E.O.) to create a national Pandemic Testing Board to increase testing capacity, expand the public health workforce, support COVID screening in schools, and ensure access to tests in underserved communities.
  • An E.O. directing studies to identify COVID treatments and ensure treatments meet the needs of diverse populations.
  • An E.O. directing federal agencies to improve data collection and reporting for high-risk populations.
  • Details on the President’s new vaccination initiative to improve the rapid and equitable distribution of vaccines.
  • An E.O. instructing the Occupational Safety and Health Administration (OSHA) to issue updated guidance on COVID-19 worker protections, and to determine whether there is a need for emergency temporary standards to protect workers from COVID-19 infections. If such an emergency rule is necessary, the strategy instructs OSHA to release it by March 15.
  • An E.O. requiring mask-wearing in airports and on certain modes of public transportation, and requiring a negative COVID-19 test before flying to the U.S. from other nations. The President also launched a “100 Day Masking Challenge” calling on Americans to commit to wearing masks for the first 100 days of his administration. He had previously acted to require face coverings and distancing for all federal buildings and federal lands.
  • An. E.O. creating a COVID-19 Health Equity Task Force to provide recommendations for allocating resources and funding in communities disproportionately impacted by COVID-19.
  • A reversal of the U.S. withdrawal from the World Health Organization (WHO). Dr. Anthony Fauci was tapped to represent the nation at the WHO’s Executive Board meeting last week.

The President plans to take additional executive actions this week. On Monday, a ‘Buy American’ E.O. directing agencies to strengthen requirements for acquiring goods and services from American businesses and workers is expected. On Tuesday, a package of E.O.s related to racial equity is expected. On Thursday, E.O.s related to health care – specifically, the so-called Mexico City policy, the Title X family planning program, strengthening of the Medicaid program, and initiating a new Affordable Care Act (ACA) open enrollment period – are expected.

Upon taking office last week, the new administration also acted to freeze all pending rules and regulations. All rules, guidance, or other agency action that did not take effect prior to noon on January 20 will be subject to review by the new administration before taking effect. If the regulations raise questions of “fact, law, or policy” the current agencies can further delay the effective dates and consult with the Office of Management and Budget (OMB) on further options.

More than 20 actions from the U.S. Department of Health and Human (HHS) are now on hold. Amongst other rules, the regulatory pause includes the Medicare Coverage of Innovative Technology (MCIT) rule, the Implementation of Executive Order on Access to Affordable Life-saving Medications rule, the Secure Electronic Prior Authorization For Medicare Part D rule, the Reducing Provider and Patient Burden by Improving Prior Authorization Processes rule, the Promoting Patients’ Electronic Access to Health Information rule, the Organ Procurement Organizations Conditions for Coverage rule, the Most Favored Nations (MFN) Model, changes to the Stark Law and Anti-Kickback Statute, and the Medicare Rebate rule.

Senate Forecast on Impeachment, Cabinet Confirmations, COVID Relief

Majority Leader Schumer has said that the top three priorities for the chamber are impeachment, confirming President Biden’s cabinet nominees, and passing coronavirus stimulus legislation. The Senate has yet to reach an agreement on organizing the rules to govern a 50-50 Senate chamber. In the interim, however, Republicans are still chairing committees and new members are not being assigned to panels. The Health, Education, Labor, and Pensions (HELP) Committee is currently awaiting a temporary GOP ranking member following the retirement of Sen. Lamar Alexander (R-Tenn.), which may delay a hearing for the presumed nominee Xavier Becerra as HHS Secretary. The Senate Finance Committee has also not yet scheduled a hearing related to his nomination. Norris Cochran, HHS Deputy Assistant Secretary of Budget, will serve as acting secretary until Becerra is confirmed. The Senate confirmed Avril Haines as National Intelligence Chief, and Lloyd Austin as Defense Secretary last week.

Senate leaders Chuck Schumer (D-N.Y.) and Mitch McConnell (R-Ky.) have reached an agreement to delay former President Donald Trump’s impeachment trial for two weeks to allow confirmation votes on President Joe Biden’s cabinet nominees. The single article of impeachment for “incitement of insurrection” will be delivered to the Senate today, but the trial will not begin until February 8.

Brian Deese, the President’s top economic adviser, met with a bipartisan group of lawmakers on Sunday to discuss the administration’s $1.9 trillion COVID-19 stimulus proposal. While the President is hopeful that the plan can be passed in a bipartisan manner, a growing number of moderate Senate Republicans have expressed concerns about the total size of the package. The plan does not yet have the support of a single Republican, though some GOP lawmakers have stated that common ground could be reached through negotiations. With the 50-50 partisan split in the Senate, the President will need the support of at least 10 Republicans in the Senate to pass the bill under regular order. Rep. Jim Clyburn (D-S.C.), member of House Democratic leadership, is encouraging the President to use his executive authority to provide economic relief if Republican hesitation delays the package’s passage. Lawmakers are reportedly aiming for a deadline of March 14 to pass the relief bill. House committees will be working on the proposal this week before the House of Representatives returns to session early next month.

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