Biden Goes Heavy on Healthcare

The president’s initiative on mental health would require insurers to cover three mental health visits a year, at no cost to members.

President Joe Biden struck a cautiously optimistic tone on the pandemic during his recent State of the Union address. The president also used the pandemic as an underlying springboard for other issues throughout his speech, which included Russia’s invasion of Ukraine, climate change, and the economy.   

Two days after his speech, the administration released a 96-page COVID preparedness plan that reflects Biden’s cautious optimism. The plan, for example, envisions acceleration of the development of a single COVID vaccine to protect against any and all new COVID variants. The plan also emphasizes the need to prevent future economic and school shutdowns ‒ and a plan to vaccinate the world.

The president also used the State of the Union as a platform to launch a mental health initiative, focusing on school-age children in particular. Part of the initiative would be to require insurers to cover three mental health visits a year, at no cost to members.

The president also talked about lowering drug and healthcare costs, including a plan to cap out-of-pocket insulin at $35 a month. That initiative has bipartisan support, so it should be a slam dunk, but analysts are saying that partisan politics may get in the way. As they say, nothing is easy in D.C.

In a related move, soon after Biden’s speech, the Federal Trade Commission (FTC) announced that it would launch a probe into pharmacy benefit managers, or PBMs, which manage prescription drug coverage. The study would look at how PBM incentives may be exacerbating drug pricing.

The president also talked about his cancer moonshot initiative, which he started when he was vice president under Obama, and which he reignited at the start of his own administration. The initiative aims to cut death rates from cancer in half before 2050.

Finally, the president set out steps his administration wants to take to overhaul the quality of nursing homes through 20 specific actions, including setting staffing levels and beefing up inspections.

You can find more information on the administration’s nursing home initiatives on the RACmonitor news site, in an article by Mark Spivey. Like many of the initiatives announced by Biden in Tuesday’s speech, the nursing home initiative will require funding, and in some cases, statutory authority from Congress.

Returning to COVID, Biden said there would soon be “test and treat” programs across the country, wherein consumers who receive a positive result from a COVID test given at a pharmacy would immediately be given antiviral therapy to fight the virus. The president said these one-stop shops would be available in 100 locations this month.

Moving away from the State of the Union, in other D.C. news, a bipartisan group of senators have introduced legislation that would update and modernize the Health Insurance Portability and Accountability Act (HIPAA) to deal with the digital age. As many of you are aware, recent interoperability rules will allow consumers to share their electronic health records with mobile apps and other third parties. Among other things, the legislation would broaden HIPAA applicability to include those third parties that are now not considered HIPAA-covered entities.  

In 2020, healthcare accounted for nearly 20 percent of this country’s gross domestic product. Federal government spending on healthcare grew 36 percent, while American household spending on healthcare increased by 26 percent.

Biden’s emphasis on healthcare in his national address is a reflection of the fact that so much of this country’s time and resources are directed toward healthcare.  

Programming Note: Listen to Matthew Albright’s live reports on federal healthcare legislation Mondays on Monitor Monday 10 Eastern, sponsored by Zelis.


Matthew Albright

Matthew Albright is the chief legislative affairs officer at Zelis Healthcare. Previously, Albright was senior manager at CAQH CORE, and earlier, he was the acting deputy director of the Office of E-Health and Services for the Centers for Medicare & Medicaid Services.

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