Skip to main content

Will President-elect Joe Biden be able to accomplish policy changes if Republicans retain control of the Senate?

While the final makeup of Congress will be unknown until the Georgia Senate runoff elections in early January, health policy experts are already considering how a divided government may tackle the industry’s biggest issues.

“The chances of a legislative agreement on much of anything are slim,” says Mark Pauly, Bendheim Professor, Department of Health Care Management, and Professor of Business Economics and Public Policy, The Wharton School.

Pauly was joined by two other University of Pennsylvania health policy experts in a recent webcast hosted by the university’s

institute for health economics. The other participants were Allison Hoffman, Professor of Law, University of Pennsylvania Carey Law School and Daniel Hopkins, Professor of Political Science, University of Pennsylvania School of Arts and Sciences, hosted by David Grande, MD, Director of Policy, Penn LDI and Associate Professor of Medicine, Perelman School of Medicine.

The experts discussed potential opportunities for health policy legislation if the make up of the government is a Biden presidency and a Republican Senate.

Executive orders and regulatory action

A lack of legislative agreements does not mean President-elect Biden can’t get things done with executive orders and regulatory action. Pauly says the biggest changes would be a Biden presidency rolling back executive orders the Trump administration put in place for non-ACA compliant, low-risk, short-term, associated health insurance plans. Hoffman says that Trump himself has done a lot with executive orders and regulatory action, which could be a route that Biden goes down as well if there is legislative gridlock.

“In the health care space, through executive orders and regulation, we’ll see an eye towards the pandemic. Things like COVID testing equipment, vaccine distribution, spending money that Congress has already appropriated for COVID response, he’ll be able to act on all of these things. Then we’ll see undoing of regulation by the Trump administration that has refused access to medical care,” says Hoffman.

This includes revisiting work requirements in the Medicaid program. Biden might also roll back a waiver to Georgia that allows them to opt out of the website and would reduce the number of people who can sign up for ACA coverage. Hoffman also expects executive orders that would return funding to Planned Parenthood, reimpose nursing home regulations that were present under President Obama, roll back of Trump’s actions on public charge status as it relates to Medicaid, and add non-discrimination protections for LGBTQ medical care.

“There’s a lot that can be done through regulatory action and the Biden administration will turn to these things pretty quickly,” Hoffman says. Another area where they could see action, she says, is in enforcing mental health parity laws, which has gone by the wayside in the Trump administration.