Weekly Policy Updates
Friday, January 29, 2021
FEHB, OPM & Federal Employees
US Office of Personnel Management Announces Key Biden-Harris Staff Appointments: Several key appointments at OPM were announced this week, including Chief of Staff Chris Canning and Associate Director of Employees Services, Rob Shriver. Several familiar names from the Obama Administration reappear. Additional information and biographical details for the nominees can be found in FCW.
Why it matters: While current Acting Director Kathy McGettigan has knowledge of the FEHB Program, note that none of the senior advisor roles are dedicated to health-related issues. Two new positions were created dedicated to improving technology, data transparency, and security. To be sure, these issues will be of top importance to OPM over the coming years.
VA Expands Vaccination to Some Non-Health Care Staff as Postal Workers Face Uncertainty: The Veterans Affairs Department is beginning to vaccinate employees beyond the front lines—at least one dose of the vaccine has been provided to 222,000 employees. Other agencies, such as the Postal Service, are waiting on state action to distribute the vaccine and have yet to see any clear plans for vaccination.
Role Reversal: Biden Rolls Back Trump’s Civil Service Directives: Biden has taken swift action to reverse several personnel decisions made by former president Trump including the controversial Schedule F executive order and limitations on union organizing. Biden has also signaled support for establishing a minimum wage of $15 an hour for Federal employees.
Why it matters: As reported in previous weeks, Biden plans to take a vastly different approach to management of the Federal workforce than his predecessor. We will continue to monitor these changes as well as distribution of the COVID-19 vaccine to Federal employees—all of which can impact employee morale, working conditions, and the ability of the government to operate smoothly.
Health Costs and Financing: Challenges and Strategies for a New Administration: A recent Health Affairs article outlines policy recommendations for 2021 focusing in on the goals of achieving access to healthcare, affordability, and equity. The authors advocate for expanded access to health insurance (including Medicaid expansion), accelerating a shift to value-based care, advancement of home-based care options, improvements to affordability of pharmaceuticals, and developing a high-value workforce.
Why it matters: Authors of this article are left-of-center moderates with extensive expertise in health policy—just the type of voices we expect the Biden Administration to be listening to. Expect to see at least some of these ideas reflected in Biden’s health priorities. Case in point, the Biden Administration recently indicated that it will allow a special enrollment period for HealthCare.gov for individuals needing coverage during the COVID-19 vaccine, in an effort to expand access to health coverage for Americans.
Regulation Tracker: Biden Reviews Trump’s Final Rules: In his first days in office, Biden halted regulations that were finalized in Trump’s final days. Modern Healthcare has developed a tracker to monitor movements on health related regulations that are under review and will keep this site updated if any changes are made.
AHIP’s Eyles: Health Policy Priorities for Insurers to Watch in 2021: AHIP CEO Matt Eyles is hopeful that the Biden Administration will pull the rebate rule, which was finalized late last year. Price transparency rules, which recently went into effect for hospitals, is also up for reconsideration.
Why it matters: Expect to see a rapidly shifting health policy landscape. Keeping a pulse on what rules the Biden Administration chooses to delay or rescind will help bring their policy priorities into focus.
U.S. Senate to Begin Work on COVID-19 Relief as Early as Next Week: Schumer: Top Democrats announced Thursday that both the Senate and the House will begin initial steps on President Joe Biden’s COVID relief plan next week. Senate Majority Leader Chuck Schumer (NY) did not offer any details about the bill, although House Speaker Nancy Pelosi (D-CA) said the House would vote on a budget resolution required to begin a reconciliation procedure. Biden’s COVID-19 proposal offers $1.9 trillion in aid and received little support from Republicans in the Senate, which dampens the possibility of a bipartisan bill.
Why it matters: Biden has weighed whether to try to pass a quicker recovery bill through reconciliation, potentially along strict party lines, or try negotiating with Republicans to get an early bipartisan victory that would likely be a substantially smaller package. These recent announcements indicate Democrats will move forward with reconciliation, potentially angering moderate Republicans hoping to be included in the deal-making process.
‘Dead on Arrival’: Trump Conviction Unlikely after GOP Votes to Nix Trial: On Tuesday, nearly all Senate Republicans voted that holding an impeachment trial for a former president is unconstitutional, signifying that the House’s case against Donald Trump is likely to fail in the Senate. The procedural vote was forced by Sen. Rand Paul (R-KY), and 45 GOP Senators ultimately voted to declare the trial unconstitutional. Only five GOP Senators – Susan Collins (ME), Lisa Murkowski (AK), Mitt Romney (UT), Ben Sasse (NE), and Pat Toomey (PA) voted with all 50 Democrats that the trial was constitutional. A two-thirds majority of 67 Senators would be required to convict Trump in the trial.
McConnell Agrees to Allow Senate Power-Sharing to Move Forward: Senate Minority Leader Mitch McConnell has backed off his demand that any Senate power-sharing agreement protect the filibuster. The agreement comes after Democratic Senators Joe Manchin (WV) and Kyrsten Sinema (AZ) confirmed they oppose disposing of the procedural tool that can be used by the Minority party to block legislation. The Senate’s 50-50 split means that Democrats and Republicans must adopt an organizing resolution, which establishes how power-sharing will work.
Why it matters: Ending the legislative filibuster was one option Majority Leader Chuck Schumer weighed to prevent Republicans from blocking legislation from reaching a floor vote. Now, the power-sharing agreement that will dictate membership numbers on committees and other elements of Senate governance will move forward.
Bipartisan Group Discussing Senate Rules Change: A bipartisan group of senators are looking at ways to make it easier to get votes on bipartisan bills on the Senate floor and increase the number of votes on amendments. The efforts seek to break the increasing legislative gridlock in the Senate, although those involved in the negotiations insist they are not close to a final deal. Neither Majority Leader Chuck Schumer (D-NY) nor Minority Leader Mitch McConnell (R-KY) are involved, although Senators Tim Kaine (D-VA), Mike Rounds (R-SD), Ben Cardin (D-MD), and Dick Durbin (D-Ill) are involved. The group is another signal that moderates in both chambers are hoping to grow their influence and cut deals under the Biden administration.
Why it matters: Moderates in both chambers are seeking to increase their influence in a closely and deeply divided Congress. There will likely be more bipartisan groups, deals, and negotiations and they will hold more weight for cutting moderate deals with the Biden administration.
How Top Payers are Providing COVID-19 Vaccine Coverage, Support: Health plans across the country are beginning to publicize details of their plans to make the COVID-19 vaccine available to their members. Strategies include: covering the vaccine at no cost during and after the public health emergency, working alongside state partners to educate the public about the vaccine, commitments to cover any future-approved vaccinations, and ensuring that members receive both doses of the vaccine. AHIP has released a vaccine resource page.
ACHP: Access to CDC COVID-19 Vaccine Data Key to Member Engagement: The Alliance of Community Health Plans (ACHP) sent a letter to the incoming coordinator of Biden’s COVID-19 response indicating that health plans need better and faster access to coronavirus vaccine administration data in order to improve vaccine distribution strategies. ACHP has indicated that identifiable data is needed to link vaccination status with claims and enrollment records in order to prioritize vaccination efforts to members with high risk factors.
Why it matters: It's all hands on deck to address the COVID-19 pandemic, insurers should have plans to be active participants in the effort.
Humana Names Nwando Olayiwola, M.D., Chief Health Equity Officer: Humana’s new Chief Health Equity Officer will be responsible for the promotion of health equity across all lines of business, defining and monitoring enterprise-wide goals, and ensuring that cultural competency is fully integrated into Humana’s operations and clinical programs.
$4 Million Initiative to Address Economic Inequity: Citing a link between economic stability and health outcomes, Kaiser has committed $4 million over 3 years to address racial disparities in access to economic inequity in Washington state. Four nonprofits were selected as grant recipients with the goals of fostering economic vitality in communities of color, providing services and capital to Black-owned businesses, and providing financial coaching and workforce support to vulnerable families.
Why it matters: The articles above highlight two trends within health insurance companies: creating senior level positions responsible for addressing health equity and cultural competency, and major investments in addressing SDOH. All insurers should be considering similar actions. You should also keep an eye on the Biden Administration’s efforts to address racial disparities.
Google Commits $150M to COVID-19 Vaccine Education, Partnering with One Medical to open Vaccination Sites: Google has committed to promote vaccine education and equitable distribution to underserved communities with a $150 million investment. The company indicated that it would stand up vaccination clinics with partner One Medical in several sites.
Why Even Presidential Pressure Might Not Get More Vaccine to Market Faster: Biden says he plans to invoke the Defense Production Act to provide more vaccine to Americans. But vaccine production will take time to ramp up—companies will need to expand current production lines, repurpose facilities, procure the required materials, and develop the appropriate infrastructure.
KFF COVID-19 Vaccine Monitor: Kaiser’s ongoing research project tracks public attitudes and experience with COVID-9 vaccines. Data released this month indicates that most Americans are not satisfied with government efforts to roll out a vaccine and about half of Americans think this will improve under the Biden Administration. Notably, less than half of Black adults are confident that vaccine distribution is taking their needs into account.
First Moderna, Now Pfizer-BioNTech Working on Booster Shot Amid Rise of COVID-19 Variants: Concerns over the efficacy of the COVID-19 vaccine against new strains of the virus are being addressed by drugmakers. Booster shots are under development to protect against new variants.
Biden Administration Aims to Have Enough Vaccine for Most Americans by Summertime: Efforts are underway to acquire an additional 200 million doses of the COVID-19 vaccine and distribute them to Americans by summer of this year. He also promised to increase the number of doses going to local governments to 10 million per week for the next three weeks.
Why it matters: Public confidence in the vaccination roll out could affect uptake of the vaccine itself and willingness to comply with recommended prevention methods, all ultimately impacting the timeline for getting the COVID-19 vaccine under control. Kaiser released a quick analysis of the number of vaccinations that need to be distributed in order to reach herd immunity by specific dates, it’s worth a read. Insurers should consider these public attitudes when developing strategies for member education and vaccination rollout.