Week Ending 2.5.2021

Weekly Policy Updates

Friday, February 5, 2021

FEHB, OPM & Federal Employees

What May Survive from Trump’s Workforce Agenda, with Many of the Signature Policies Gone: In his first days as President, Joe Biden has eliminated several of former-President Trump’s federal workforce agenda including limitations on collective bargaining and a prohibition on race and diversity training. However, some of Trump’s agenda will likely remain. In particular, Trump Administration efforts to improve employee engagement and reskill the workforce are likely to stay on the table with some tweaking under Biden’s leadership. Trump’s attempts to reorganize OPM ultimately failed, but the debate did bring attention to OPM and a new conversation is likely to emerge about how to strengthen and modernize the agency.

The Government Agencies that Became Smaller, and Unhappier, Under Trump: Under former President Trump, an already aging federal workforce and outdated civil service processes took some significant hits due to his approach to workforce issues. All but 5 of the core cabinet level agencies shrank in size and the overall employee satisfaction level saw a drop in 2019 (2020 data isn’t yet available).

Why it matters: While we don’t yet have full details on Biden’s plans for a federal workforce strategy, we do know that some of the problems that were exacerbated by the Trump Administration will need to be addressed. Namely, low morale, an aging workforce, and agencies with a high level of unfilled positions. As the agency responsible for federal hiring, benefits, and HR policy, OPM is often at the center of these conversations.

Lawmakers Aim to Dissolve ‘Draconian’ Law That Placed Heavy Financial Burden on Postal: A bipartisan group of lawmakers in the House and Senate have introduced legislation that would remove a requirement that the Postal Service prepay retirement benefits. This requirement has long been cited as hindering the Postal Service’s ability to remain financially stable.

Why it matters: While the legislation mentioned above only addresses the requirement to prefund retirement benefits, other efforts to bolster the Postal Service have included changes to their employee health benefits. This is a perennial issue and one that FEHB carriers should monitor.

Policy Updates

Medicare Buy-In for Older Adults Could Cut Health Costs, Increase Coverage Value: Urban Institute: The Urban Institute released a report indicating that, when implemented alongside the ACA, a Medicare Buy-In program could result in more generous coverage, lower out-of-pocket spending for beneficiaries, and lower oval healthcare spending by $1.8 billion.

How Might Xavier Becerra Operate as HHS Secretary?: Democrats are supportive of Becerra’s nomination, citing his extensive background in health policy and his support of the ACA. Conservatives, however, point to Becerra’s longstanding support of Medicare for All as a significant concern.

Why it matters: Biden has indicated support for a Medicare Buy-In program. We expect to see debates on this issuing during his term. Becerra’s nomination to HHS and Bernie Sander’s role as ranking member on the Budget Committee could help clear the pathway for this highly partisan policy shift, though both have supported more sweeping Medicare for All proposals rather than Medicare Buy-In.

‘Vote-a-rama’ to Give GOP a Chance to Inflict Pain on Dems: On Thursday, the Senate undertook a “vote-a-rama” marathon voting session to begin the process of passing a budget resolution and potentially starting a reconciliation procedure. Early Friday morning, the stimulus package was approaved by the Senate. President Kamala Harris cast her first tie-breaking vote. During the vote-a-rama, Republicans proposed several controversial amendments including reducing funding for the state of New York, prohibiting funding for schools that do not reopen for in-person classes, and blocking funding for sanctuary jurisdictions. The Democratic party will likely use reconciliation to pass President Biden’s $1.9 trillion coronavirus relief package with a simple majority. The $15 federal minimum wage, which had been included in the package, did not pass. Senator Bernie Sanders plans to make another attempt to increase the minimum wage during the reconciliation process.

Why it matters: The “vote-a-rama” presents an opportunity for Republicans to delay work on a budget resolution and force painful votes for moderate Democrats. Even using reconciliation, Democrats will still need to remain entirely united on the entire package to pass it, which will mean some uncomfortable compromises for both the moderate and progressive wings of the party.

Schumer and McConnell Agree to Organizing Resolution for 50-50 Senate: Senate Majority Leader Chuck Schumer (NY) and Minority Leader Mitch McConnell (KY) reached an agreement on an organizing resolution to dictate power-sharing in the evenly split Senate. The resolution allows Democrats to take control of committees and did not include any protections for the legislative filibuster McConnell initially requested. The resolution passed in the Senate Wednesday.

Why it matters: With Democrats in charge of committees, they will be able to expedite the lagging process to confirm President Joe Biden’s cabinet and other appointees. Democrats will also now have control over setting much of the legislative agenda in the body.

GOP Courts Biden, Who Signals He Might Move Without Them: After a Monday evening meeting with 10 Senate Republicans, President Biden urged Senate Democrats go “go big and move quickly” on coronavirus relief. The plan proposed by the Republican group was a $618 billion package which they argued would have bipartisan support. However, the deal was panned by the President and Treasury Secretary Janet Yellen who warned a smaller deal would leave the economy struggling to recover. Biden and Congressional Democrats will now likely move forward with the President’s $1.9 trillion proposal, even without any Republican support.

Why it matters: Biden had initially hoped to begin his presidency with a bipartisan win on COVID relief, but the Republican offer did not present a convincing starting point for potential negotiations. Now the President will prioritize unifying the Democratic caucus on quickly passing a larger package through reconciliation. However, the move to shut Republicans out of negotiations may negatively impact some members willingness to cooperate on other items of the Administration’s legislative agenda.

Industry Updates

3 Big Predictions for Digital Health in 2021: Experts weigh in on the use of technology in healthcare and agree that we are likely to see: a shift towards predictive tools such as AI, a continued reliance on telehealth, and a focus on cybersecurity.

Humana and Cigna Report Q4 Losses: Citing costs associated with the COVID-19 pandemic and deferred care, both Cigna and Humana have reported losses in Q4 of 2020.


Variation in Telemedicine Use and Outpatient Care During the COVID-19 Pandemic in the United States: In a review of data from January to June 2020, researchers found that 30.1% of all outpatient visits were provided via telemedicine. However, telemedicine usage was lower in communities with higher rates of poverty and varied greatly by specialty. Healthcare Dive provides a summary of the article.

Why it matters: If telehealth is here to stay as experts predict, the healthcare industry will need to grapple with new health disparities that may arise due to access issues and implications for specialty providers. Understanding these downstream affects will help insurers develop a strategy for the continued use of telehealth that meets the needs of its members and provider network.

Biden Administration Will Ship COVID-19 Vaccines Directly to Pharmacies: Beginning on February 11, about 1 million COVID-19 vaccines a week will begin to be delivered directly to pharmacies across the country.

Why it matters: The Biden Administration is attempting to address equity concerns when it comes to access to the vaccine. We should expect to see specific, targeted efforts to ensure that all Americans who want the vaccine can get it. As a major player in the vaccination effort, health insurers should follow this example and ensure that their vaccination strategy includes intentional efforts to encourage vaccination among members of all races/ethnicities, socioeconomic status, and geographic location.

These States Found the Secret to COVID-19 Vaccination Success: States with smaller populations have seen better results in percentage of their residents vaccinated. Successful states started their planning early, relied on local drug stores rather than chain pharmacies, and run their operations from a central point. West Virginia, Alaska, South Dakota, Maine, New Mexico, and North Dakota are all ahead of the pack.

Biden Administration Awards $231M to Increase US Production of At-Home, OTC COVID-19 Test: At-home COVID-19 testing may become a reality after the US Department of Defense awarded a contract to an Australian-based company for 8.5 million antigen tests for nationwide distribution. The test will be available without a prescription.

U.S. Response to Coronavirus Variants Emphasizes Masks and Vaccines Instead of Lockdowns: As new strains of the COVID-19 virus have been found, Americans have tired of strict lockdown measures. Public health officials are turning to wearing a mask (or two), avoiding crowds, and vaccination as keys to ending the pandemic.

Why it matters: Insurers have a role in disseminating information to members about the most up-to-date safety recommendations, testing options, and state programs to receive the vaccine. Staying abreast of trends in this space should help insurers develop a cohesive communications strategy.

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