2020: The Only Certainty is Uncertainty

Expect to see legislation on bipartisan issues, such as drug pricing and balance billing.

The Associated Press and broadcast networks announced on Saturday that former Vice President Joe Biden has won the 2020 presidential election.

The Trump campaign and Republican groups have initiated a number of election-related lawsuits across the battleground states, and there are also a number of formal actions that need to take place before Biden is officially considered the president-elect, including expected recounts in a number of states and the certification of votes, for which some states can take until Dec. 8 to complete.

These formal, post-election activities are expected to go forward without incident, as they have for all elections within recent memory, but, of course, this is 2020, and nothing is certain.

Assuming Biden is sworn in on Jan. 20, a priority for both Congress and the president-elect is the coronavirus. There is some chance that a relief package will be passed during the lame-duck session, as both the Republican Senate and House Democrats continue to say they want agreement on a package; however, much rests on President Trump at this point, and his goals for what happens between now and the end of January.   

In terms of control of the Senate, it is currently a tie – both the Democrats and the Republicans have 48 senators each, leaving four Senate races that have yet to be concluded, including a run-off in January in Georgia for both of the state’s Senate seats.

However, whether the Democrats or the Republicans take the Senate, the impact on healthcare policy is likely to be the same under a Biden presidency. If Republicans retain their majority in the Senate, then it will be difficult for Biden to pass any major healthcare legislation, such as his proposed public option. And even if the Democrats do gain a small edge in the Senate, it will be difficult for healthcare legislation to pass without some help from moderate Senate Republicans.

That being said, we can expect to see legislation on bipartisan issues, such as drug pricing and balance billing, and Biden is expected to beef up the Patient Protection and Affordable Care Act where he can, through executive orders and regulations.

Speaking of the Affordable Care Act, lest we forget, the Supreme Court will hear arguments in the case that could overturn the act on Tuesday, Nov. 10. Many legal analysts, both those supportive and opposed to the Affordable Care Act, doubt that the court will overturn the entire law. However, like everything else this year, that is not a guarantee.

While arguments will be heard for a couple of hours Tuesday, the Supreme Court is not expected to make an actual decision on the case until June of next year.

That gives a little time for Congress to make the whole case go away by legislating a price tag on the individual mandate – say, a dollar – or repealing the individual mandate altogether. Either action from Congress would make the case moot, because the lawsuit is based on the question of what the congressional intent is with regard to the individual mandate.

However, like we said, it may be difficult for Biden to pass major healthcare legislation regardless of who runs the Senate – and, in the current political environment, mandating a dollar penalty for not buying health insurance has become a major point of contention.

Programming Note: Matthew Albright is a permanent panelist on Monitor Mondays. Listen to his legislative update sponsored by Zelis, Mondays at 10 a.m. EST.