Biden Preps Health Initiatives, While Trump Could Issue More Rules

While President-elect Joe Biden’s transition team is hitting the ground running in preparation for Jan. 20, the Trump administration could issue some rules now that can be in effect by Inauguration Day – and some of those rules could impact health care.

That was among the takeaways during a Manatt Health webinar on how the 2020 election results will impact health care.

Right now, Congress is in its lame-duck session, and is likely to address some health care priorities, said Joel Ario, Manatt managing director. Congress faces an appropriations deadline of Dec. 11.  In addition, with Pfizer and Moderna announcing plans to submit their COVID-19 vaccines to the Food and Drug Administration for emergency use authorization shortly, Congress must approve funding for distributing the vaccine.

Trump administration rules issued now can be in effect by Inauguration Day, said Allison Orris, Manatt counsel. Some of those rules could include drug pricing rules for drugs covered under Medicaid and Medicare Part D, and more approvals of Section 1115 waivers for states that want to waive federal Medicaid guidelines.

Meanwhile, the Biden administration has a number of key positions to fill and win Senate confirmation. Health-related positions that must be filled include Health and Human Services secretary, deputy secretary and assistant secretaries; Centers for Medicare & Medicaid Services administrator, National Institutes of Health director, FDA director and Office of Management and Budget director.

Early executive actions of the Biden administration, Orris said, include extending the COVID-19 public health emergency declaration, pulling back on selected Trump-era rules and guidance, and pursuing new COVID-19 flexibilities.

With two Senate seats from Georgia remaining to be filled in a January election, control of the Senate is still unknown, said Ian Spatz, Manatt senior advisor. The Senate is split at 50 Republicans and 48 Democrats, while Democrats in the House of Representatives retained a slim lead following the Nov. 3 election.

Although “Biden is a creature of the Senate,” having served there for 36 years and having many relationships among its members, if Congress is under split control, the possibility of health care reform is limited, Spatz said. He outlined some possible scenarios:

• COVID-19 relief. A split Congress may limit the scope of a relief package, while a Democratic Congress would likely pass a larger package.
• Both a split Congress and a Democratic Congress are likely to address Medicare insolvency, while a Democratic Congress is expected to lower the Medicare eligibility age to 60.
• Medicaid and the health insurance marketplace. A Democratic Congress is expected to pass a public option to expand Medicaid in states that did not expand it under the Affordable Care Act as well as to expand ACA subsidy eligibility and value.
• Drug pricing. A split Congress is likely to take action on reducing Medicare Part D out-of-pocket costs, while a Democratic Congress would purse more aggressive reforms including allowing Medicare to negotiate prices.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].