Health Policy News – January 2021

Even though we are only one month into 2021, an incredible amount of health policy developments have transpired since our last edition! We have several updates in this first edition of 2021, all of which include a nod to the recent change in U.S. leadership and pending federal appointments by the Biden administration. Because this edition covers a period spanning the previous and current presidential terms, we note throughout that the Biden administration is likely—and in some cases, has already begun—to review all of the Trump administration’s actions, including those made in its final weeks.

Just yesterday (January 28th), President Biden issued “Executive Order on Strengthening Medicaid and the Affordable Care Act”, in which he directs applicable agency heads (those of Labor, Health and Human Services, and Treasury) to review all existing regulations, orders, guidance documents, policy, and similar agency actions to ensure that they are consistent with the policy set forth in his order: “to strengthen Medicaid and the ACA and to make high-quality healthcare accessible and affordable to every American.” This broad review authority is likely to impact commercial and public health plan operations, and Health Policy News will be closely tracking the results.

As has been the case since March 2020, this month’s edition contains updates related to the COVID-19 pandemic. One piece outlines the challenges states have faced in obtaining and distributing the vaccine; another, federal-level policy actions and changes on the horizon as the Biden administration takes office.

On January 8th, 2021, the Centers for Medicare and Medicaid Services (CMS) announced the approval of Tennessee’s final Medicaid Block grant proposal, which was originally submitted in 2019. Our piece on the topic outlines a few key elements of the waiver, and previews likely legal challenges that could delay or impede implementation of the sweeping reforms therein.

Lastly, on January 19th, CMS finalized portions of the Notice of Benefit and Payment Parameters for 2022 (NBPP). This edition features a brief overview of the finalized policy changes, as well as highlights what aspects of the annual Exchange guidance have yet to be finalized.

We hope that each of you had a restful end to 2020, as we are likely to see a flurry of policy-related activities over the coming weeks and months. As always, Health Policy News will provide timely updates and analysis on applicable health policy developments as they occur.

How States Can Improve COVID-19 Vaccine Distribution 

The COVID-19 pandemic has been the greatest public health crisis of our lifetime—but fortunately, it has been met with a scientific response  equally as strong. As the US enters its third month of COVID-19 vaccinations, this piece reflects on the initial rollout’s shortfalls and successes, as well as how the process can be improved on a national level. To read more, click here.

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Update on the Federal Response to the COVID-19 Pandemic as Leadership Changes

COVID-19 was the top focus of the new federal administration as it entered office this month. With the surge in cases continuing across the nation, President Biden signed a number of COVID-19-related executive orders upon taking office and has also outlined his plan for the future. Additionally, CMS has continued issuing new guidance and waiver approvals over the last several weeks. This article includes information and resources on each of these developments, as well as key provisions that were signed into law at the end of 2020 as part of the 2021 appropriations bill. Click here to learn more.

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First-of-Its-Kind Tennessee Block Grant Approved by CMS

On January 8th, 2021, CMS announced the approval of Tennessee’s final Medicaid Block grant proposal, which the state had originally submitted in 2019. However, this waiver approval is likely to face legal disputes similar to those raised after the approval and implementation of work requirements/community engagement eligibility standards in states like Arkansas and Kentucky. To read more about the waiver approval and potential challenges to its implementation, click here.

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CMS Finalized Exchange Guidance for 2022

CMS finalized the NBPP on January 19th, 2021, just as the Trump administration was leaving office. The former president’s administration chose to focus on limited but significant policy changes in quickly finalizing the rule, while leaving more basic provisions like cost-sharing limits pending. The 2022 Letter to Issuers on the Federally-facilitated Exchanges has also not yet been finalized, leaving some key guidance in proposed form as the Biden administration entered office. With a new administration at the helm, it is likely that the controversial provisions that were finalized in the NBPP—including those related to direct enrollment and Section 1332 Waivers—will be revisited, and the entire rule will likely be subject to a regulatory freeze. To review the final NBPP provisions and likely next steps, click here.

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