KHN’s ‘What the Health?’: The long road to unwinding Trump health policies

Reviewed by Emily Henderson, B.Sc.Jan 28 2021

Thursday was "health day" in President Joe Biden's sprint to launch his presidency, and he signed two executive orders addressing health coverage and women's reproductive rights. The orders will reopen enrollment under the Affordable Care Act from February to May and reverse the so-called Mexico City policy that limits funding to international health groups that perform or support the right to abortion.

Meanwhile, the Biden administration said it is nearing a deal to purchase enough doses of covid vaccine for every American age 16 and older, but Congress is still working through organizational details and has not yet decided how to proceed on the president's relief proposal.

This week's panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Shefali Luthra of The 19^th.

Among the takeaways from this week's podcast:

• It is unclear how many people will use the new ACA enrollment period on healthcare.gov, but Biden's decision to reopen the marketplace is an effort to draw a comparison between his priorities and those of the Trump administration, which refused to reopen the exchange after the pandemic took hold last year.
• The 12-week special open enrollment period being set up by the Biden administration is twice as long as last fall's regular enrollment period, and it comes during tax season. Many ACA advocates suggested years ago that sign-ups be held when people are doing their taxes and might have refunds to help pay their premiums.
• The administration is feeling deadline pressure on a decision about how to handle the Trump administration's embrace of work requirements for some adults enrolled in Medicaid. If officials want to make a change in policy, they may need to get that implemented before the Supreme Court hears arguments in a case challenging the work requirements.
• Although Xavier Becerra's nomination to be Health and Human Services secretary has not seemed to gain any urgency on Capitol Hill, it could pick up some Republican support since senators likely know him from his many years serving in the U.S. House.
• It's notable that Biden hasn't yet nominated anyone to head up the Centers for Medicare & Medicaid Services, a key part of HHS. During the Trump administration, there were tensions between HHS Secretary Alex Azar and CMS Director Seema Verma, and the Biden administration is likely seeking to be careful to not have that happen again.
• Democrats, concerned that Biden's proposal for a new covid stimulus package may not gain bipartisan support, are preparing efforts to push parts of the package through in a special congressional maneuver called budget reconciliation that requires only a majority vote and is not subject to a filibuster in the Senate.
• One aspect of the vaccine distribution that has been sorely missing is a strong messaging campaign about the benefits of getting a shot. National celebrities, as well as leaders and local officials trusted by the public, are needed to get the word out.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: Stat's "'But I Never Smoked': A Growing Share of Lung Cancer Cases Is Turning Up in an Unexpected Population," by Sharon Begley

Joanne Kenen: The New Yorker's "The Blackwell Sisters and the Harrowing History of Modern Medicine," by Casey Cep

Shefali Luthra: The 19^th's "Undocumented Women Are Among the Most Vulnerable to COVID. Vaccinating Them Will Be Difficult," by Shefali Luthra and Chabeli Carrazana

Mary Ellen McIntire: The New York Times' "Biden Is Vowing to Reopen Schools Quickly. It Won't Be Easy," by Dana Goldstein