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Washington Update: Biden Administration Pandemic Response, Proposed Reforms Impacting Practice

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ACP continues to advocate for patients and physicians, update members

Feb. 19, 2021 (ACP) – The new presidential administration is rapidly overhauling the nation's approach to health care amid the COVID-19 pandemic, but some proposed reforms will take time to work through the legislative process. The American College of Physicians has two missions during this crucial transition period: engage in advocacy on the front lines and keep members up to date.

“Quite a lot is happening here in Washington, D.C., right now, and our members are already feeling the impact as President Biden and his staff settle in and make progress,” said Bob Doherty, ACP senior vice president for governmental affairs and public policy. “At ACP, we're working every day to monitor the ever-evolving political situation and speak to those in power on behalf of physicians and patients.”

ACP has applauded the president for signing a series of executive orders. Among other things, the orders will boost the national response to the pandemic, end discriminatory bans on immigration and restore the United States to its proper role as a worldwide health leader. Physicians in particular will gain from a continued pause on federal student loan repayments.

Here are recent developments from the Biden administration:

  • The Centers for Disease Control and Prevention has required the wearing of protective masks on public transportation. In general, this rule encompasses transportation outside of private cars, including planes, trains, subways, buses and even taxis and ride-share vehicles. The order also includes points of departure such as train and bus stations.
    “We earlier called for a national mask requirement on all public transportation and on federal facilities,” Doherty said. “Up until now, enforcement was pretty much left up to companies like the airlines. They haven't had the weight of the federal government saying to a passenger: ‘You've got to comply, or you're going to be fined.’ Now that's changed.”
  • The U. S. Department of Health and Human Services told governors that the federal public health emergency has been extended through late April, and it's likely to continue to be in place for the rest of 2021.
    “This is very good news because a declaration of a public health emergency allows a lot of crucial things to happen, such as the new coverage rules for payment for telemedicine,” Doherty said. “Many programs have been authorized because we're in a declared emergency, and it's reassuring to know the rug won't be pulled out from under them.”
  • A $232 million deal inked by the Biden administration will allow the federal government to buy at-home rapid COVID-19 tests from an Australian company.

Other responses to the pandemic will require congressional approval. In Feb. 10 letters to congressional leaders, ACP declared that it strongly supports components of COVID-19 relief legislation. “We believe that many of the actions outlined in these proposals will help physicians and our patients,” said Dr. Jacqueline W. Fincher, president of ACP. “We need to ensure that we bring the pandemic under better control as quickly as possible, and we need to ensure that no one is forced to go without health care during this time while everyone's health is under threat.”

In a letter to the House Ways and Means Committee, ACP expressed support for plans to reduce health care premiums for low- to middle-income Americans through increased tax credit subsidies; to subsidize COBRA coverage; and to provide premium subsidies for unemployed workers who are ineligible for COBRA. ACP believes the tax credits should be extended permanently.

And in a letter to the House Energy and Commerce Committee, ACP discussed its support for provisions to incentivize states to expand Medicaid to all low-income persons, increase coverage for women's health care services and accelerate efforts to distribute vaccines and COVID-19 testing. ACP supports the higher levels of funding proposed in the legislation for vaccines, testing and contact tracing and for community health centers and the public health workforce.

ACP added that it supports provisions related to Medicaid that would require the program to cover COVID-19 vaccines and treatments, extend postpartum coverage for women who were enrolled in the program while pregnant and increase federal funding to states to expand Medicaid.

If passed, the federal funding could convince the 12 remaining states that haven't expanded Medicaid access to do so, Doherty said. “ACP has been long in favor of expanding Medicaid in every single state in the country and the District of Columbia,” he said.

The proposed legislation would be part of an overall COVID-19 relief package. Many Republicans in the Senate have signaled they will oppose the larger bill because of concerns about cost and scope, even though they may agree with some of the specific provisions in it related to COVID-19. To prevent them from using the filibuster to block the package from becoming law, “Democrats have decided to use an alternative strategy known as budget reconciliation, which can't be filibustered and requires only a simple majority vote to pass,” Doherty said.

“ACP is not in a position to evaluate whether budget reconciliation is the best way to move things forward,” he added. “But we are certain that we must move forward. We'll continue to advocate for a full and robust federal response to this pandemic.”

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Back to the February 19, 2021 issue of ACP Advocate