Healthcare Takeaways from President Biden's First 100 Days

The Biden healthcare agenda has had a significant impact on the industry beyond the response to the COVID-19 pandemic.

President Joe Biden addressed a joint session of Congress for the first time in his tenure Wednesday night to reflect on his first 100 days in office and outline his forward-looking policy proposals.

While the speech primarily focused on the aspects of Biden's proposed $1.8 trillion American Families Plan, which aims to address child care, student debt, and tax reform, among other areas.

But the speech also touched on several healthcare topics, including the administration's handling of the COVID-19 pandemic, rolling out vaccines to virtually all Americans, and bolstering the Affordable Care Act (ACA) through a three-month special enrollment period.

Related: How Will the Biden Healthcare Agenda Impact Health Systems?

The speech received a welcome response from healthcare stakeholders.

Bruce Seigel, MD, MPH, CEO of America's Essential Hospitals, released a statement applauding the Biden administration's "vigorous" public health effort to combat COVID-19 and distribute vaccines nationwide.

"The president cautioned there is still work to do to beat the virus, and we agree — we must ensure our hospitals and other front-line providers have the federal funding and other support they need to meet current and future challenges," Seigel said. "So, we urge the administration to devote sustainable and robust support to Medicaid and other safety net programs and to prioritize essential hospitals’ infrastructure needs, including technology and workforce, as we emerge from the pandemic. As cornerstones of community health and economic activity, essential hospitals will be central to the nation’s recovery."

The Campaign for Sustainable Rx Pricing (CSRxP) commended Biden for calling on Congress to lower prescription drug prices this year.

“We applaud the President for calling on Republicans and Democrats to work together to advance urgently needed solutions to lower prescription drug prices,” Lauren Aronson, executive director of CSRxP, said in a statement. "This is a top priority for American voters who need relief from Big Pharma’s egregious pricing and anti-competitive practices, and we look forward to working with the administration and Congress to get the job done this year."

'Busy' 100 days

Heather Meade, a principal at Washington Council Ernst & Young, told HealthLeaders that Biden's first 100 days in office have been "busy."

In analyzing Wednesday night's speech, Meade said that executives should take note of what was included in the address and what was not.

From a healthcare perspective, the American Families Plan largely focuses on reforms for long-term and care outside the hospital, Meade said.

However, she also noted that Biden spoke about establishing an agency within the Department of Health and Human Services (HHS) dedicated to research on cancer and Alzheimer's disease. This research initiative, spurred by the success of Operation Warp Speed in the effort to combat COVID-19, is one that could generate bipartisan support, she added.

Biden did discuss a potential extension of the ACA tax credits that were included in the most recent stimulus package, albeit in passing. 

"When you think back to the Obama era through the Trump era, every address to Congress has focused heavily on healthcare, including a big focus on their vision for affordability and access to coverage. But we really didn't spend as much time on those issues [last night,]" Meade said. "Instead, what Biden focused on was making permanent the expansion of the ACA tax credit, which is a significant coverage expansion that was passed as part of the last relief package. It's an important gap in the market that they're looking to address, but notably, [the speech] didn't include in some of the other big proposals that were part of his agenda."

Related: What Healthcare Finance Leaders Need to Know About the $1.9T Stimulus Package

There were two major health policies that did not get outlined in detail during the address, according to Meade, which were plans to lower prescription drug prices and expand Medicare coverage through the introduction of a public option.

Meade stated that the lack of a unified plan to address drug pricing, as well as tight margins on the Democratic control in both houses of Congress, currently limits which policies can be pursued by the Biden administration.

Due to the potential for an incremental approach on Capitol Hill, Meade said the administration may shift focus to exercising executive and regulatory powers on certain healthcare items rather than through legislative action.

Still, Meade said healthcare executives should acknowledge that policy proposals are subject to change in Washington, D.C.

"I think it's important for your audience to recognize that [the American Families Plan] is the administration's proposal, and while we've seen Congress hue closely to proposals as they've been presented by the administration in each of the last relief packages, we've seen additional policies added that are sometimes in the healthcare space," Meade said. "We've also seen policies come out because of the legislative reconciliation process being used because some of the proposals didn't fit in that package. So, we could see some priorities move around as Congress aims to implement and legislate on these priorities."

Where will Biden take healthcare?

Michael P. Strazzella, is head of federal government relations at Buchanan, Ingersoll and Rooney, a law firm and lobbying group based out of Pittsburgh.

Strazzella told HealthLeaders that while Biden has been active in healthcare policy over his first 100 days in office, he hasn't fully hit his stride in terms of pursuing potential policy goals.

Strazzella attributed part of this stall to the hold placed on the confirmation process for Chiquita Brooks-LaSure, Biden's nominee to serve as Centers for Medicare & Medicare Services Administrator.

Related: Stakeholders Discuss Biden Healthcare Agenda

He added that the administration will also have to wait and see how the Supreme Court rules in California v. Texas, the pending case that could invalidate the ACA.

"[The administration] will be reacting to that, so it's hard to be able to predict when we don't know which direction [the court] is going to go. But I think that will be agenda item number one; that's a big question of how to respond," Strazzella said. "The second is around Medicare eligibility and being able to lower that. I think some of that will come into play on budgetary issues; with each feature you add on, what does that do to the solvency of the Medicare program?"

As it relates to policies that could affect provider organizations, Strazzella praised Biden's selection of Liz Fowler to lead the Center for Medicare & Medicaid Innovation, citing her experience promoting value-based purchasing models.