HEALTH CARE BRIEFING: Biden Win Signals Shift in Virus Response

By Brandon Lee

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President-elect Joe Biden’s victory signals a turning point in the nation’s response to the coronavirus pandemic, as he promises a newly aggressive federal effort to contain a virus that is spiking nationwide in contrast to a president who has consistently downplayed the outbreak’s dangers and promised it would disappear.

But while the president-elect can begin to lay the groundwork for a more muscular approach and a vastly different messaging campaign than President Donald Trump, Biden will have to wait until he is officially inaugurated on Jan. 20 to put any of those plans into place.

Still, Biden’s transition team has been working for months on how to coordinate federal agencies to execute the plans Biden outlined months ago. The proposals include a national mask mandate, although Biden has acknowledged that would be difficult to enforce except on federal property.

“I will bring together Republicans and Democrats to deliver economic relief to working families, schools, and businesses,” Biden said in St. Paul, Minn., on Oct. 30. “As I’ve said before, I’m not going to shut down the economy. I’m going to shut down the virus.”

Biden released a plan to combat the coronavirus that says its aim is to restore trust, create a cohesive national strategy, make treatments affordable, provide economic relief to those impacted by the virus and work with other countries to combat the spread.

Biden said he would restore the White House National Security Council Directorate for Global Health Security and Biodefense, which the Trump administration had folded into another office at the NSC. He also plans to provide a daily public White House report on how many tests have been conducted, expand surveillance programs by the U.S. Centers for Disease Control, instruct federal agencies to take action to expand America’s hospital capacity and expand tele-health capabilities across the country.

The plan also says federal health agencies will collaborate on vaccine development, establish a public health corps to assist with testing and contract tracing, and fully fund and expand authority for the National Disaster Medical System to reimburse providers for Covid-19 treatment costs that are not directly covered by health insurance.

The coronavirus pandemic, which has already killed more than 230,000 people in the U.S., is likely to intensify in the cold months between the election and inauguration, so Biden’s administration will have to be ready to address a fluid situation immediately. So while he cannot yet act, Biden and his team will spend the next several weeks gathering information about the Trump administration’s response and ensuring they are ready to implement Biden’s plans after he takes the oath of office.

“A lot is going to depend on how we’re doing,” Ezekiel Emanuel, a former top health adviser to the Obama administration, said in an interview before Election Day. “Most of us, the physicians, public-health community fear that we’re going to have outbreaks in large numbers because of people going inside” as the weather cools.

Biden has been urging Americans to heed the advice of scientists and public health experts since the onset of the pandemic in March, and advisers said he made a strategic decision early on to model his presidential campaign in line with his beliefs about how a president should behave in a crisis. He spent most of the early months of the pandemic campaigning from his basement in Wilmington, and once he resumed in-person events, he strictly followed social distancing and masking guidelines. Read more from Tyler Pager and John Tozzi.

Biden’s Covid Task Force to Play Key Role in Pandemic Response: Biden today announced a new coronavirus task force as his transition team seeks to fulfill a campaign promise to develop a dramatically different approach than Trump’s to contain the pandemic. The 13-member task force is composed largely of doctors and public health experts, who will work with Biden, Vice President-elect Kamala Harris and the transition team to map out the public health and economic policies needed to curtail the virus.

The team will be led by former Surgeon General Vivek Murthy, former Food and Drug Administration Commissioner David Kessler, and Marcella Nunez-Smith, a professor of public health at Yale University. It will include about a dozen people, many of whom were already advising Biden and his staff throughout the campaign. Kessler and Murthy, in particular, were deeply involved in shaping the Biden campaign’s plans for responding to the virus, and they both regularly briefed the president-elect. Other members include Luciana Borio, Rick Bright, Ezekiel Emanuel, Atul Gawande, Celine Gounder, Julie Morita, Michael Osterholm, Loyce Pace, Robert Rodriguez, and Eric Goosby. The task force will brief Biden and Harris today. Read more from Tyler Pager.

  • Biden’s health-care advisers have held talks with pharmaceutical-industry executives in which they discussed Operation Warp Speed, the U.S. research and development effort for coronavirus vaccines and treatments, according to people familiar with the matter. Biden advisers met with companies that have Covid vaccines or therapies in late-stage clinical trials in September and October, the people said, to gather information about the manufacturing and distribution of shots to ward off the novel coronavirus and therapies to treat the sick. Read more from Riley Griffin.

Stimulus Unlikely Before January: Biden’s victory in the presidential election and the unresolved status of Senate control leave slim prospects for a major fiscal-stimulus package before January. While Trump last month pledged a large post-election stimulus act, it was based on his assumption that he’d win re-election. He now has little political incentive — or capital — to drive a deal through a divided Congress in his remaining weeks in office.

Democratic and Republican lawmakers were quick to restate their opposing positions on Friday as Biden closed in on his win. Senate Majority Leader Mitch McConnell (R-Ky.) cited falling unemployment in arguing for a “highly targeted” relief bill. Speaker Nancy Pelosi (D-Calif.) rejected that idea, saying “that isn’t something we should be looking at.” Read more from Erik Wasson and Jordan Fabian.

Biden’s First Day Plans: Joe Biden has a lot of plans for his first day as president, and some of it can actually happen in a single day. Biden has promised to reverse Trump’s rollbacks of public health and environmental rules and call allies worldwide to reassure them, all on his first day in the White House. Before that day is done, he says he will rejoin the World Health Organization, among other actions. Read more from Jeffrey Taylor, John Tozzi, Greg Stohr and Jennifer A. Dlouhy.

Biden Win Augers Windback of Trump Health, Science Policies: Biden’s win signals a 180-degree shift for multiple health policies Trump pushed over the last four years, many of which landed in court. The Biden administration will likely withdraw from several lawsuits the Trump administration is appealing, including state work requirements for Medicaid and regulations that allow health-care providers to decline to treat LGBT people. The Department of Health and Human Services under Biden also will likely take steps to wind back rules boosting availability of short-term insurance plans. Read more from Lydia Wheeler, Tony Pugh, Jacquie Lee and Jeannie Baumann.

Biden Mulls Top Health Appointees: Apart from Biden’s coronavirus task force, he has proposed creating a special position to oversee the response to the pandemic. Separately, the leading contenders to head Health and Human Services are two women who Biden also considered for vice president: Rep. Karen Bass (D-Calif.), head of the Congressional Black Caucus, and New Mexico Gov. Michelle Lujan Grisham (D). Read more from Max Berley on possible cabinet appointments across the government here.
Related: Biden Begins Transition But Cabinet Picks Are Weeks Away

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More on the Pandemic

Covid Cases Near 10 Million in U.S.: Close to 10 million Americans have been diagnosed with Covid-19 in the past 10 months, and with the start of winter just a month away, and the public increasingly likely to spend more time cooped up inside, the virus shows few signs of slowing down. Infections are setting sequential daily records with the US reporting more than 126,000 new infections for the third consecutive day over the weekend and deaths remaining at more than 1,000 daily for a fifth day. Infections are expected to soar further as cold weather grips northern states, schools and businesses try to reopen, people move their daily activities inside and the holidays spur gatherings, health officials and experts said. Read more from Michelle Fay Cortez.

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Dems Sticking With Health-Care Push After Losses

Democrats are sticking to their health-care messaging even as that strategy didn’t resonate as they had planned in last week’s election.

House Democratic leaders leaned heavily on the agenda they believe earned them a majority two years ago: expanding the Affordable Care Act while deflecting the Trump administration’s attempts to undercut it, and lowering drug prices. This year, they came up short of growing their House majority or capturing the Senate.

Election observers say health-care issues weren’t as salient for many voters this election, even given the pandemic, and Republicans gained ground in key races by painting their opponents as extremists and generating substantial turnout.

“This election was more about people’s identity than health care,” Gregg Bloche, who was a health-care adviser to former President Barack Obama’s 2008 campaign and now teaches law at Georgetown University, said. “Democrats generally do better when it’s about health care.”

Democratic-aligned groups say they’re now retooling their health-care message in Georgia, where two races could determine control of the Senate in coming months. They’ll be aided by the fact that a legal challenge to the ACA will reach the Supreme Court this week. Read more from Alex Ruoff.

Obamacare Stakes Rise at High Court as Election Dooms Easy Fix: Democrats’ failure to secure a Senate majority in last week’s election has heightened the importance of Tuesday’s Supreme Court showdown over the Affordable Care Act, increasing the chances the court will get the final word on a law that provides health insurance to 20 million people.

The Trump administration is joining Republican-led states in challenging the law, known as Obamacare, which the GOP has been trying to wipe out since it was enacted in 2010. They’re banking on the court’s strengthened conservative majority with new Justice Amy Coney Barrett.

With health care accounting for a sixth of the U.S. economy, the stakes were massive even before the election made Democrat Joe Biden the president-elect while leaving Republicans favored to retain control of the Senate. Now the prospect of a divided government could leave Democrats without the ability to override a ruling invalidating the law. Read more from Greg Stohr and Lydia Wheeler.

Senate Committees’ Upcoming Health-Care Agenda

Control of the Senate remains unclear, and Republicans and Democrats are both preparing for the possibility that the chamber’s majority will remain in flux until January’s runoff in Georgia. Despite the uncertainty, committee leadership and priorities for the 117th Congress are taking shape. Read our full report here.

Health, Education, Labor and Pensions: The Senate Health, Education, Labor, and Pensions Committee’s ambitions for next year will range from responding to the Covid-19 pandemic to tackling thorny health-care legislation. Sen. Richard Burr (R-N.C.) was set to take over the top GOP spot from retiring Chairman Lamar Alexander (R-Tenn.), but an investigation into his stock sales made as the virus was spreading around the globe prompted him to step aside as head of the intelligence panel, leaving the future of both in flux. Lobbyists and aides say the GOP leadership role may instead go to Rand Paul (R-Ky.), who hasn’t laid out his priorities. Sen. Patty Murray (D-Wash.), an experienced hand, will likely retain the top Democratic spot.

Burr would likely pursue many of Alexander’s priorities from 2020, including surprise medical bills, drug prices, and an update to the Higher Education Act. Paul has advocated for expanding health savings accounts and reducing the role of government in health care. Read more from Andrew Kreighbaum, Alex Ruoff, and James Rowley.

Finance: Meanwhile, Sens. Mike Crapo (R-Idaho) and Ron Wyden (D-Ore.) look to be the top members of the Finance Committee for their parties. Crapo would bring a reputation as a low-key but active policymaker from his last four years leading the Banking Committee, while Wyden has served as Democrats’ top voice on the panel for several years. As chairman, either would have a powerful position for negotiating broad health-care and tax provisions if Congress and the administration choose to move forward on a fresh round of pandemic aid, if that remains a live issue past the lame-duck session of this current Congress.

Though he has a professional background in tax law, much of Crapo’s body of work at the Finance Committee has focused on health policy, and he figures to re-engage on prescription drug pricing in the new Congress. Crapo objected to aspects of bipartisan drug pricing legislation (S. 2543) introduced by current Finance Committee Chairman Chuck Grassley (R-Iowa) last year, opposing mandatory drug rebates companies would pay if their prices rose beyond inflation. Crapo introduced his own bill (S. 3129) that paralleled Grassley’s in some ways—like an out-of-pocket cap for seniors—but without mandatory rebates.

Other potential agenda items for health care include making permanent the temporary flexibility around telehealth care brought by congressional and Executive Branch action during the Covid-19 crisis, and shoring up Medicare’s funding. Read more from Colin Wilhelm and Jacquie Lee.

Veterans’ Affairs: The expansion of health-care options outside the Department of Veterans Affairs and the shift to a new electronic health record system are among the issues that the Senate Veterans’ Affairs Committee will likely tackle next year. Jerry Moran (R-Kan.), who took over as chairman in January following the retirement of Johnny Isakson (R-Ga.), is poised to return as the panel’s top Republican if the GOP holds a majority. Jon Tester (D-Mont.) will likely stay on as top Democrat, either as the chairman or its ranking member, but he also could pursue an opening on the Indian Affairs Committee. Read more from Michael Smallberg.

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To contact the reporter on this story: Brandon Lee in Washington at blee@bgov.com

To contact the editors responsible for this story: Zachary Sherwood at zsherwood@bgov.com; Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com

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