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A Weekly Health Policy Round Up From Health Affairs            

**February 14, 2021**

THIS WEEK ON THE BLOG

FOLLOWING THE ACA

Biden Justice Department Formally Changes Positions In California v.
Texas

By Katie Keith (2/12/21)

Upon reconsideration, the Department's new position is that the
individual mandate, even with a $0 penalty, remains constitutional. Even
if the Court finds the mandate to be unconstitutional, the Department
now believes it should be fully severable from the rest of the ACA
(meaning the rest of the law would stand). Read More >>

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Unpacking The Coverage Provisions In The House Pandemic Relief Drafts

By Katie Keith (2/9/21)

On February 8, 2021, the Ways and Means Committee and the Education and
Labor Committee of the US House of Representatives each released draft
legislative text for the budget reconciliation legislation that
Democrats are pursuing for additional pandemic relief. The drafts are
the next step in a process that began when both chambers passed a 2021
budget reconciliation resolution last week. Read More >>

ACA Round-Up: Health Plan Filing Deadlines, Affordability Data,
Association Health Plan Litigation, And More

By Katie Keith (2/9/21)

Over the past few weeks, the Centers for Medicare and Medicaid Services
has released new guidance and data related to the Affordable Care Act
(ACA). In addition, several pending ACA-related lawsuits have been
resolved or delayed. Read More >>

COVID-19

****Just-In-Time Versus Just-In-Case Pandemic Preparedness

By Joshua Barocas, Celine Gounder, and Syra Madad (2/12/21)

A just-in-time approach to pandemic preparedness by medical supply
manufacturers, hospitals, and governments has failed during the COVID-19
pandemic. A just-in-case strategy with training plans, stockpiles,
infectious disease surveillance, and stakeholder coordination is the
solution to future health crises. Read More >>

Four Recommendations To Efficiently And Equitably Accelerate The
COVID-19 Vaccine Rollout

By William F. Parker, Govind Persad, and Monica E. Peek (2/11/21)

Successful COVID-19 vaccination distribution requires efficient and
equitable operationalization of national guidelines at the local level.
We offer four recommendations for doing so.
Read More >>

A Call To Action: Immediate Deployment Of Select Repurposed Drugs For
COVID-19 Outpatient Treatment

By Vikas P. Sukhatme and Vidula V. Sukhatme (2/9/21)

During the COVID-19 emergency, a small group of the most promising
FDA-approved drugs could be repurposed for COVID-19 using temporary
treatment guidance by a government agency and/or health care systems.
Tools to track outcomes should be made readily available and data
analyzed in real time. Read More >>

****

COSTS & SPENDING

Health Care Reform: One (Percent) Step At A Time

By Zack Cooper and Fiona Scott Morton (2/10/21)

High US health care costs are the result of a series of discrete
problems that each incrementally raises health spending by a percent or
two. We call these the "one percent problems" and have brought together
experts to identify these problems and describe evidence-based steps to
address them. Read More >>

HEALTH EQUITY

Dreams Of A Beloved Public Health: Confronting White Supremacy In Our
Field

By Ryan J. Petteway (2/9/21)

Health equity is not something that is "achieved," because this implies
the absence of conflict. Equity scholars must be explicit in our
language and goals, and judicious in our choice of research questions
and methods, all of which must be rooted in antiracist, critical race,
and decolonizing frameworks. Read More >>

SUBSTANCE USE

Responding To COVID-19: Supporting People In Recovery From Opioid Use
Disorder

By Karen A. Scott, Kenneth Shatzkes, and Lydia Tschoe (2/11/21)

Access to treatment for opioid use disorder is important, but so is
ensuring access to recovery services, which provide social connections
and other supports to help people rebuild their lives. A national
foundation has awarded grants to organizations helping to provide safe
and meaningful recovery support services during the pandemic. The
authors suggest policy interventions-for new Biden administration
staffers and others addressing the opioid crisis-on the critical
importance of recovery services. Read More >>

SYSTEMS OF CARE

To Make Progress, Focus On Building Trust

By Lisa Simpson and Sachin H. Jain (2/10/21)

At least three dimensions of trust are essential to addressing the
health and health care challenges ahead: trust within historically
disenfranchised communities to achieve equity; trust in science and
scientific innovation; and trust in health care itself. Read More >>

Hospital Price Transparency Could Change The Face Of Medical Debt
Collections, If Advocates Exploit It

By Jackson Williams (2/11/21)

With some assistance, uninsured patients, or those who are out of
network with a hospital, should be able to leverage the newly available
information in hospital price reports to fend off hospitals' attempts
to collect excessive charges. Read More >>

NURSING HOMES

These Administrative Actions Would Improve Nursing Home Ownership And
Financial Transparency In The Post-COVID-19 Period

By Charlene Harrington, Anne Montgomery, Terris King, David C.
Grabowski, and Michael Wasserman (2/11/21)

The growth in complex nursing home ownership structures has limited
financial transparency by allowing nursing homes to hide public payments
and stint on direct resident care.
Read More >>

LEGAL & REGULATORY ISSUES

Budget Reconciliation: A Powerful Tool To Set Bipartisan (Seriously!)
Health Policy

By Richard Sorian (2/8/21)

Reconciliation has become a highly partisan approach to legislating.
While it's unlikely that the new Congress and president will move back
toward bipartisanship, the opportunity exists. Read More >>

HEALTH AFFAIRS BRANDED POST

POLL: Medicare Advantage Beneficiaries are Highly Satisfied with Their
Coverage and Eager to Protect It

By Allyson Y. Schwartz
Supported by Better Medicare Alliance

Even as health care workers and other essential personnel worked
feverishly to meet the demands of the COVID-19 pandemic, too often, the
story has been one of personal loss, shared disappointment and
uncertainty, and failure of our systems and institutions.
Read More >>

IN THE JOURNAL

EYE ON HEALTH REFORM

Biden And New Congress Tackle COVID-19, ACA

By Katie Keith

Before previewing what lies ahead for the new Congress and the Biden
administration, Katie Keith takes note of the actions at the end of the
previous Congress, including new COVID-19 relief, the No Surprises Act
(patient relief from surprise out-of-network providers' bills), and
the Competitive Health Insurance Reform Act. Keith also reviews what
actions the new Democratic-controlled Congress could take in striking
down some of the Department of Health and Human Services-related rules
issued in the waning days of the Trump administration. Looking ahead,
Keith notes that the new Congress and the Biden administration could now
make some adjustments to the Affordable Care Act (ACA), such as expanded
subsidies.
Read More >>

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Our February issue features six commentaries from the National Academy
of
Medicine's (NAM's) Vital Directions for Health and Health Care
project, which proposes health and health care priorities for the new
Biden administration. The cluster

includes these articles:

* Vital Directions For Health And Health Care: Priorities For 2021

Victor J. Dzau of the National Academy of Medicine and coauthors
identify the overarching theme of this series as "the clear and urgent
obligation for the US to turn its full attention to the growing problem
of health inequities and to the structural racism that perpetuates
[health] disparities."

* Infectious Disease Threats: A Rebound To Resilience

Peter Daszak of Ecohealth Alliance and coauthors review pandemic
preparedness in the US and outline steps to strengthen our ability to
anticipate and respond to future pandemics.

* Optimizing Health And Well-Being For Women And Children

Elena Fuentes-Afflick of the University of California San Francisco and
coauthors draw upon a life-course framework to identify promising
interventions to improve the health of women and children.

* Actualizing Better Health And Health Care For Older Adults

Terry Fulmer of The John A. Hartford Foundation and coauthors identify
six strategies to improve care and quality of life for older adults.

* Transforming Mental Health And Addiction Services

Margarita Alegría of Harvard Medical School, Massachusetts General
Hospital, and Mass General Research Institute and coauthors describe new
models of care that focus on mental health and addiction.

* Health Costs And Financing: Challenges And Strategies For A New
Administration

William H. Shrank of Humana and coauthors discuss health costs and
financing priorities to advance health care access, affordability, and
equity.

This initiative was originally established by the NAM in 2016 with the
goal of providing the US presidential administration as well as other
policy makers, opinion leaders, and the public with nonpartisan,
evidence-based analysis of the most compelling opportunities and
priorities in health, health care, and biomedical science. The resulting
2017 publication brought together some 150 policy experts to provide
guidance on 19 priorities. In 2020, the NAM reassessed the priorities
and issues of urgent attention for the next administration; today's
cluster of commentaries is the result of the NAM's recent review.

The publication of the Vital Directions series in

**Health Affairs** was supported by the Gordon and Betty Moore
Foundation, The John A. Hartford Foundation, the National Academy of
Medicine, and the Robert Wood Johnson Foundation.

HEALTH AFFAIRS PODCAST

What The Biden Administration Urgently Needs To Address In Health Care

Listen to Health Affairs Editor-in-Chief Alan Weil interview Victor
Dzau, president of the National Academy of Medicine, on the new Vital
Directions publication, how health equity is fundamental for shaping
health system reform, and why science should embrace social and
behavioral disciplines.

Listen here.

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CANCER

The Effect Of The Affordable Care Act On Cancer Detection Among The
Near-Elderly

By Fabian Duarte, Srikanth Kadiyala, Gerald F. Kominski, and Antonia
Riveros

Fabian Duarte and coauthors show that the reduction in the rate of
uninsurance among adults ages 60-64 due to the Affordable Care Act
greatly increased rates of cancer detection for this population.
Fifty-nine additional incidents of cancer were detected per 100,000
people, and 68 percent of these were early- and middle-stage
cancers-and thus more likely treatable. Read More >>

MEDICARE

The Impact Of Medicare On Access To And Affordability Of Health Care

By Paul D. Jacobs
             
Using data from the Medical Expenditure Panel Survey-Household
Component and the National Health Interview Survey, Paul Jacobs tested
for changes in access to care and affordability around age sixty-five,
when most people gain eligibility for Medicare. Read his findings on
accessibility and what they mean for proposals to lower the age of
Medicare eligibility. Read More >>

MEDICAID

Medicaid Physician Fees Remained Substantially Below Fees Paid By
Medicare In 2019

By Stephen Zuckerman, Laura Skopec, and Joshua Aarons

Stephen Zuckerman and coauthors update previous studies of Medicaid
physician fees to assess how Medicaid fees compared with Medicare fees
in 2019 across states and service types. Read More >>

DISABILITY

Physicians' Perceptions Of People With Disability And Their Health
Care

By Lisa I. Iezzoni, Sowmya R. Rao, Julie Ressalam, Dragana
Bolcic-Jankovic, Nicole D. Agaronnik, Karen Donelan, Tara Lagu, and Eric
G. Campbell

How confident are US physicians that they can provide the same quality
of care to patients with disability as to those without? Lisa Iezzoni of
Harvard Medical School and coauthors surveyed physicians about their
perceptions of care for people with disability. Read More >>

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Breaking Down The 2021 Momnibus Bill

Listen to Health Affairs editors Leslie Erdelack and Jessica Bylander
discuss what's in the Black Maternal Health Momnibus Act of 2021.

Listen here.

HEALTH POLICY VALENTINES

It's that time of year again when we send health policy valentines
across Twitter. This year Editor-in-Chief Alan Weil got in on the action
when he heard the news that the

**Wall Street Journal** was going to use "health care" as one word from
now on.

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About Health Affairs

Health Affairs is the leading peer-reviewed journal
at the intersection of health,
health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
through healthaffairs.org , Health Affairs Today
, and Health Affairs Sunday
Update .  

Project HOPE is a global health and
humanitarian relief organization that places power in the hands of local
health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

Copyright © Project HOPE: The People-to-People Health Foundation, Inc.

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