During the early days of cinematography, it was common for the lights in a movie theater to be turned on as an employee mounted the stage to make the following announcement, “One minute please while we change reels.” Federal health policy in the United States often is implemented in a similar manner. Regardless of the many alterations made during any presidential administration, as soon as a new president arrives on the scene from the opposing political party, several items are at a high risk of being reversed. Some examples of changes that have been made by the Biden Administration are as follows:
The regular Affordable Care Act sign-up period ended on December 15, but President Biden signed an executive order launching a special 90-day enrollment period for ACA coverage, which began on February 15. The Administration seeks to increase public awareness of the extended timeframe through a $50 million marketing campaign.
An executive order directs the U.S. Department of Health and Human Services (HHS) to review the interoperability of public health data systems across the nation. The objective is to improve COVID data sharing throughout the federal government, enhance vaccine distribution, and increase the understanding of the scope of the pandemic in communities throughout the country.
The following rules proposed by the Centers for Medicare and Medicaid Services (CMS) during the Trump administration have been withdrawn: Conditions for Coverage for End-Stage Renal Disease Facilities—Third Party Payments; Strengthening Oversight of Accrediting Organizations (AO) and Preventing AO Conflict of Interest, and Related Provisions; and Revisions to Medicare Part A Enrollments.
Unwinding Medicaid Work Requirements
The Biden Administration has expressed strong interest in beginning the process of rolling back Medicaid work requirements, an initiative developed when President Trump was in office, which generally mandated that beneficiaries log 20 or more hours on a job, look for work, perform community service, or take educational classes to be eligible for Medicaid benefits. Kentucky, Arkansas, and Nebraska are among 12 states that received federal approval to impose such requirements, although some plans were blocked by the courts. A possibility remains that some states may elect to challenge these roll back efforts.
Concentration Of Health Care Expenditures
A significant portion of health legislation is aimed at controlling health care costs. In the newest Statistical Brief, data from the Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey Household Component (MEPS-HC) describe the overall concentration of health care expenses across the U.S. civilian noninstitutionalized population in 2018. Spending on health care that year accounted for 17.7% of the U.S. gross domestic product, yet the majority of this spending was concentrated in a small percentage of the population. Older individuals disproportionately were represented in the higher healthcare spending tiers. Among the entire U.S. civilian noninstitutionalized population in 2018, 16.8% were 65 and older, while 22.6% were under age 18. Among the top 5% of spenders, however, 39.0% were 65 and older, while only 5.8% were children under age 18. In contrast, among the bottom 50% of spenders, 30.6% were children while only 6.0% were 65 years and older.
Steady growth in the portion of individuals age 65 and older in the population will have an impact on efforts to lower health care spending due to the amount of money that will be spent on addressing their health care needs. The most commonly treated condition among the top 5% percent of spenders in 2018 was hypertension (48.8%), followed by osteoarthritis/other non-traumatic joint disorders (44%), and nervous system disorders (40.0%). While these conditions are the most common among high spenders, they are not necessarily the most expensive ones to treat. Instead, the top spending group is more likely to include patients with multiple chronic conditions or expensive treatments (e.g., surgeries, and hospitalizations) related to these conditions.
More February 2021 TRENDS Articles
PALIMSEST
Discusses how this term can be viewed metaphorically in considering how topics are updated and revised in successive issues of the newsletter TRENDS. Read More
AMERICAN RESCUE PLAN AND COVID-19
Lists how separate components of various congressional bills are combined into overall reconciliation legislation. Read More
HEALTH REFORM DEVELOPMENTS
Looks at how an incoming new Administration goes about reversing policies established by the previous set of office holders. Read More
DEVELOPMENTS IN HIGHER EDUCATION
Points out some ramifications associated with making it free to attend public institutions, reduce student debt, and control the spread of coronavirus on campus. Read More
QUICK STAT (SHORT, TIMELY, AND TOPICAL)
Sexual Orientation Disparities In Risk Factors For Adverse COVID-19-Related Outcomes
Instant Death More Common In Absence Of Physical Exercise
Identifying Candidates For Drug Repurposing For SARS-CoV-2
Affordable CRISPR App Reveals Unintended Mutations At Site Of CRISPR Gene Repair Read More
OBTAINABLE RESOURCES
Voluntary Support Of Education
National Healthcare Quality And Disparities Report
50-State Survey Of Telehealth Commercial Insurance Laws Read More
THE PRODOME: DIAGNOSIS, DISADVANTAGE, AND BIOMEDICAL AMBIGUITY
Examines how the prodome as an emerging phase of illness can create problems for patients, their families, and health care institutions. Read More
IMPLICATIONS OF GENETIC TESTING FOR SUICIDE RISK
Pertains to a discussion regarding the possibility that polygenic risk scores eventually may be used regarding suicide death and some concerns once any product is commercialized and marketed directly to consumers. Read More