Week Ending 2.12.2021

Weekly Policy Updates

Friday, February 12, 2021

FEHB, OPM & Federal Employees

IT Modernization is a Priority for Biden’s OMB Pick, But She Acknowledges Funding Challenges: A hearing was held to vet Biden’s pick for OMB Director, Neera Tanden. Tanden plans to focus on the use of technology to increase government efficiency. The article also points out that Pam Coleman has been appointed as OMB’s associate director for performance management.

Why it matters: As associate director for performance management, Pam Coleman will have oversight over OPM functions. Pam previously led personnel services for the state of New Mexico and in the White House Presidential Personnel Office.

Leaders in Washington Region Ask FEMA for Help in Vaccinating Federal Workers: Washington DC senior leaders are asking the federal government to provide vaccines for federal workers, rather than DC having to dip into its own supply of vaccinations.

Lawmakers Want Federal Employees to Get Administrative Leave for COVID Vaccinations: Several Democratic lawmakers penned a letter to OPM requesting that they allow federal employees to take administrative leave in order to receive the COVID-19 vaccine.

Why it matters: Insurers will have an important role in facilitating access to the COVID-19 vaccine for the federal employees they serve. Understanding the rights and flexibilities available will be key to a successful rollout of vaccines to federal employees.

Making Congress a Better Place to Work: The Brookings Institute recently released a report with recommendations for improving working conditions. Relying on information provided in a report from the House Committee on the Modernization of Congress, Brookings included a recommendation that Hill staff be allowed to either rejoin the traditional FEHB Program or be allowed to utilize their local ACA marketplace rather than the DC Health Link, as is currently required. Both reports cite problems with finding local providers when covered by a DC-based plan.

Why it matters: The regulation requiring Members of Congress and certain congressional staff to obtain health insurance through the DC Health Link’s SHOP has long been controversial. However, concerns about network adequacy seen unfounded. Many of the options available via the SHOP have nation-wide networks and the SHOP website even lets shoppers filter by network coverage, allowing them to select and view only plans with nation-wide coverage.

Policy Updates

Biden Admin Changes DOJ’s Position in Pending Supreme Court ACA Case: The Supreme Court is currently considering a case that could invalidate the entire Affordable Care Act. However, with the recent change in Administration, the Department of Justice has reversed the government’s position in the case and now supports the idea that even without the individual mandate, the rest of the law would remain constitutional. The Supreme Court heard oral arguments on the case last November and is expected to make a decision soon.

Health Care and Employer Groups Announce Principles to Protect Patients and Achieve Universal Coverage: A coalition of health care and employer groups has released a set of principles for achieving universal coverage in the U.S. These principles include protecting people who lose their employer-sponsored coverage, increasing ACA premium tax credits and cost-sharing reductions, establishing a reinsurance fund, restoring funding for outreach and enrollment programs, automatic enrollment and renewal for individuals eligible for Medicaid or premium-free ACA plans, and providing additional incentives for Medicaid expansion.

Why it matters: While the future of the ACA is still uncertain, we now having a shifting landscape in which the Administration is in full support of the law. Statements from key industry players would indicate their support for not only maintaining but strengthening the ACA. The outcome of the Supreme Court decision will have sweeping implications for the health insurance industry and, if overturned, we do expect quick action from the President and legislature to enact new legislation, a process that would take quite a bit of time and energy away from other priorities in Washington.

House Democrats Propose Multibillion-Dollar COVID-19 Relief Health Package: The House Energy and Commerce Committee, which has jurisdiction over many healthcare issues, will review the multibillion-dollar COVID-19 relief health package Thursday. The proposal includes billions of dollars for vaccine distribution and monitoring, COVID testing, enhancing public health infrastructure, and expanding health coverage under Medicaid. The proposal’s priorities largely mirror the framework previously released by President Biden.

Why It Matters: Under the budget reconciliation process, specific committees in the House must review certain sections of the larger budget before voting on the consolidated package in the full chamber and sending to the Senate. The bills large size is potentially a barrier to Republican support. Controversial sections of the whole package, such as raising minimum wage or Medicaid expansion, may be altered or removed to pass through the Senate.

Democrats push temporary Obamacare expansion in Covid bill: On Monday, the House Democrats released their COVID-19 relief bill that includes the first expansion of Affordable Care Act subsidies in over a decade. The provision would fully subsidize ACA coverage for people making up to 150% of the federal poverty level and people on unemployment insurance. It also ends the “subsidy cliff” which makes people making over 400% of the federal poverty level eligible for subsidies and caps their premiums at 8.5% of their income. The subsidy provisions would only be valid for 2021 and 2022 but could later be extended or made permanent.

Why It Matters: ACA subsidies were part of President Joe Biden’s health care agenda. Democrats hope that enhanced subsidies combined with Biden’s recent executive order reopening the ACA marketplace will help lower the numbers of uninsured Americans in the wake of the pandemic.

Senate Votes Trump Trial Is Constitutional, Hears Opening Arguments: This week, the Senate began the impeachment trial of former President Donald Trump. After a Tuesday vote upheld the constitutionality of the trial by a 56-44 vote, House Impeachment managers presented their arguments on Wednesday and Thursday. Now, GOP senators say the trial could end as early as Saturday as Trump’s legal team has indicated it will wrap up its defense on Friday.

Why It Matters: At its current pace, Trump’s impeachment trial will be significantly shorter than any other presidential impeachment trial. This indicates that both sides anticipate an acquittal and would like to prevent a weeks-long process of hearing from witnesses so they can turn their attention to the incoming COVID relief package and other priorities.

Black Maternal Health Omnibus Package Introduced by Democratic Lawmakers: Representatives Lauren Underwood (D-Ill) and Alma Adams (D-N.C.) alongside Senator Cory Booker (D-N.J.) announced Monday an omnibus bill aiming to combat inequities for Black mothers. The package would fund community organizations and governments trying to improve maternal health outcomes, training programs on bias and racism, and efforts to grow the perinatal workforce. Additionally, the bill would address things like access to housing, food, and water that affect maternal health outcomes.

Why It Matters: Black women are three times more likely than white women to die from complications related to pregnancy. Unequal access to care, racism and bias in the health system, and social determinants of health all contribute to these outcomes. Vice President Harris was a lead sponsor for the Senate version of the bill that was introduced last year, and the Congressman reintroducing the bill hope the new administration will help pass it in this Congress.

Industry Updates

Highmark Health Commits $1.5 Million to Increase Diversity Leadership in Pittsburgh: Highmark Health, the parent company of the Highmark health insurance company, has invested $1.5 million dollars to help establish and maintain an endowment for increasing the number of African Americans in executive leadership positions. This move is part of Highmark’s 5-part diversity, equity, and inclusion strategy addressing health disparities and inequities, community engagement, minority talent representations, market outreach, and supplier diversity.

Why it matters: Highmark’s strategy stands out as a great example of the internal and external facing components that are required to truly move the needle—their strategy includes efforts to reduce disparities for members, increase diversity within their own organization, and support external efforts (talent pipelines, vendors, etc.).


People of Color Especially Don’t Know Where or When to Get a COVID-19 Vaccine: Kaiser Family Foundation recent survey results illustrate that Black and Hispanic adults don’t feel they have adequate information about where and when to get a vaccine.

White House to Ship COVID-19 Vaccines Directly to Community Health Centers: Focusing on equitable distribution of the vaccine, the White House announced that vaccines will be distributed directly to community health centers. One million doses will be sent to 250 clinics in the first phase of the program during the next few weeks. While specific clinics haven’t yet been selected, priority will be given to clinics that serve people experiencing homelessness, agricultural and migrant workers, residents of public housing, and those with limited English proficiency.

Why it matters: These articles reiterate what we have reported in previous weeks—racial and ethnic disparities exist not only in access to the vaccine itself, but in access to information about how to receive the vaccine. As a major player in the vaccination effort, health insurers should ensure that their vaccination strategy includes intentional efforts to encourage vaccination among members of all races/ethnicities, socioeconomic status, and geographic location. We expect to see continued efforts from the Biden Administration to address equity concerns as part of their vaccine roll out efforts.

FDA Issues Emergency Use Authorization for Eli Lilly’s COVID-19 Antibody Combo: Emergency use for a new combination antibody drug from Eli Lilly has been granted. The drug treats mild to moderate cases of COVID-19.

New COVID-19 Cases in US Drop Below 100,000: For the first time this year, new cases of COVID-19 fell below 100,000 and hospitalizations continued to decline. At the same time, cases of the new variant, which is highly contagious, have been doubling every week and a half. About 9.5% of the US population has received the vaccine, with numbers varying by state.

Why it matters: Sharing some good news that new treatment options are becoming available, the vaccine is making its way (slowly) into the arms of the public, and new cases appear to be on the decline. The CDC is still emphasizing prevention efforts, such as the use of properly fitted masks.

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