Participate in any conversation these days (socially distanced, of course) and the topic will almost always eventually turn to the subject on everyone’s mind: have they yet received the COVID-19 vaccine and, if not, when do they anticipate receiving it? From state to state, and even from county to county, the answers can vary markedly. News stories about uneven distribution of vaccines, frozen websites, and long waits in line to get inoculated illustrate the logistical challenge and rising expectations for the new administration.
President Biden’s team has said that taming the COVID pandemic and administering the vaccine to 100 million Americans during the Administration’s first 100 days will dominate their health agenda. To that end, the President issued an Executive Order within hours of being inaugurated mandating mask-wearing on federal property and challenging Americans to wear masks for 100 days. While this will ensure that every member of Congress, and every staff member, will need to comply, it remains to be seen if governors and mayors, who have the ultimate control here, will support the Administration’s lead. The Alliance actively supports efforts to promote regular use of masks to help slow the spread of COVID-19. Additionally, the President is creating the new position of COVID-19 Response Coordinator, who will coordinate all elements of the COVID-19 response across government, including managing efforts to produce, supply, and distribute personal protective equipment, vaccines, and tests. The already uneven supply chain as well as fear of a mutating, highly contagious strain will require an “all hands on deck” approach to stall the advance of the pandemic. As the initial stage of vaccine rollout progresses, reaching vaccine-hesitant populations will be essential. The Alliance is already working to increase education around the vaccines authorized for emergency use by the FDA and address equity concerns as a co-convener of the COVID-19 Vaccine Education and Equity Project.
Beyond this initial action focused on the pandemic, the Biden Administration faces other contentious issues, including nursing home reform, continuing Medicare coverage of telehealth visits, modification of HIPAA regulations that were relaxed during the pandemic, and escalating prescription drug prices. Nursing home reform, possibly including staffing ratios, higher salaries for workers, and oversight will most likely be part of this Administration’s legislative agenda. Any reforms should also include changes to ensure federal guidelines align with appropriate clinical use of antipsychotics in facilities. Financial support for in-home caregivers will also receive increased attention as part of an overall effort to strengthen Medicare and Medicaid. The most ambitious Administration proposal could require a $500 billion increase in funding for home and community-based long-term care.
The new Administration is also expected to continue their efforts to lower drug prices, but it remains to be seen if bipartisan support can be forged on any approach. President Biden’s plan would repeal the existing law that currently bans Medicare from negotiating lower prices with drug manufacturers and require drug companies to apply those negotiated prices to the commercial markets. Consumers would also be able to buy cheaper priced prescription drugs from other countries, which could help mobilize competition. While there is general agreement that United States consumers pay the bill for pharmaceutical innovation that benefits patients worldwide, there is also concern that forcing “big pharma” to lower its prices could result in stalling this essential innovation, the importance of which has been evident in the breathtaking speed in which highly effective COVID-19 vaccines have been developed. Another more palatable approach that might find bipartisan support and deliver relief to consumers: lowering the price for Medicare Part D and B pharmaceutical benefits, including through a cap and smoothing policy.
With the Inauguration behind us, Washington is preparing for what will be an active, and no doubt contentious, legislative session. Will the Administration’s success—or lack thereof—in managing the COVID-19 pandemic impact support for the President’s other legislative priorities? If Americans can once again go to the movies, eat in restaurants, and gather with their families and friends, they may be more willing to answer Biden’s call for bipartisan action. If the pandemic is still curtailing American’s lives well into the legislative year, the Administration will no doubt face a steep uphill battle.
Jim Scott serves as the chair of the Alliance for Aging Research’s Board of Directors. He is also the president and CEO at Applied Policy in Washington, D.C.
