IMPAQ Health News
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In this edition, learn about the Biden administration’s COVID-19 plans, related executive actions in the new president’s first week, and more. Have you taken our reader survey? We want to hear from you. 
Developing and using a common set of measurable goals that reflect shared priorities across systems and communities can help align decisions, policies, and practices—and achieve more equitable health and well-being. To aid that effort, the American Institutes for Research (AIR), with funding from the Robert Wood Johnson Foundation, developed five Guiding Principles to Align Systems with Communities To Advance Equity through Shared Measurement. (IMPAQ is an affiliate of AIR.)
COVID-19
COVID-19 Case and Variant NewsThe United States has exceeded 25 million confirmed coronavirus cases, just over a year after the first case was detected in the country. However, the number of COVID-19 hospitalizations and new daily case data suggest a downward trend after the surge of cases experienced over the holidays.

 
  • The increase in variant strains could affect vaccine efficacy. However, a recent study found that the Pfizer vaccine should be just as effective against the U.K. variant. Moderna has begun testing a booster shot in the hopes that it will be more effective against the new South Africa strain of the virus. The company is also testing another booster shot option that has been developed to broadly defend against new variants.

Biden Administration's COVID-19 Actions. Newly inaugurated President Joe Biden announced his coronavirus plan last week, setting a goal of administering 150 million vaccine doses in his first 100 days as president.
 
  • President Biden also reimposed restrictions on non-U.S. citizens traveling into the country from Europe and added Brazil and South Africa to the list of restricted countries.
 
  • The new president also issued an executive order calling for federal agencies to clarify the obligations of insurance companies regarding the cost of COVID-19 testing.
 

Vaccine Supply Updates. Many states are concerned about vaccine supply shortages and the unpredictability of shipments. States report that they have not received adequate information to effectively plan vaccine distribution, leading to many appointments being canceled.
 
  • Vaccine manufacturers say they are on track to meet their vaccine supply targets. Johnson & Johnson has committed to supplying 100 million doses of its one-shot vaccine by the end of June, if authorized in the coming weeks. President Biden plans to purchase an additional 100 million doses from both Pfizer and Moderna. This purchase would increase the national vaccine supply to 600 million, but shortages may continue, as the new supply would be delivered this summer.
Here are some resources for following health policy trends and the latest efforts to address COVID-19: 
  • The National Academy for State Health Policy tracks which states are reporting race and ethnicity in their COVID-19 case, testing, mortality, and vaccination data. Only 22 states are currently reporting race and/or ethnicity in their vaccination data.

  • Johns Hopkins University frequently updates its worldwide map of confirmed COVID-19 cases and deaths. 


Rules & Reports
CMS’ new price transparency rule, which took effect on January 1, 2021, requires hospitals to make different types of prices available to all patients, including gross charges, discounted cash prices, and payer-specific negotiated charges. Hospitals must also make a consumer-friendly list of their 300 most shoppable services available to the public. The rule attempts to make health care prices more accessible and transparent to patients. Health Affairs (1/19)

  • Check out IMPAQ’s new blog that recaps recent health cost transparency efforts and explores what’s next for this important issue.
The final 2022 payment notice, released earlier this month, will allow states to use decentralized enrollment through insurers rather than a centralized marketplace like HealthCare.gov. The rule was published one day before President Biden’s inauguration, and his administration is likely to delay and revise it. Health Affairs (1/15)
President Biden’s Health-Related Executive Orders & Appointments
The economic downturn and increase in unemployment caused by the pandemic led millions of Americans to lose health care coverage. President Biden signed an executive order on January 28 to reopen HealthCare.gov from February 15 to May 15 to give Americans the opportunity to sign up for ACA plans. People shopping on the marketplace will not need to provide proof of job loss to enroll. White House officials expect that many states that run their own marketplaces will also reopen enrollment. Washington Post (1/28)

  • A recent analysis from the Kaiser Family Foundation shows that reopening enrollment in the ACA Marketplace means that 8.9 million Americans would be eligible for free or reduced-cost ACA plans.
President Biden demonstrated a commitment to increased equity for underserved communities in a recent executive order that requires federal agencies to conduct equity assessments and allocate resources to invest in these communities. White House (1/20)
Biden Nominates and Appoints Additional Health Officials
President Biden has begun to nominate and appoint key officials and positions in federal health agencies. Dr. Rochelle Walensky, sworn in as the new CDC director last week, faces the task of rebuilding trust between the agency and the public, as well as battling the pandemic. Dr. Rachel Levine has been nominated for assistant HHS secretary. If confirmed by the Senate, she will be the first openly transgender federal official. Until President Biden nominates a candidate for CMS administrator, Elizabeth Richter will fill the position in an acting capacity.
The Biden administration has delayed a Trump administration final rule that would require community health centers to charge low-income patients the acquisition price plus an administration fee for insulin and Epi-Pens in order to receive future federal funding. The rule is delayed until at least March 22, though President Biden’s team may choose to withdraw it altogether. Modern Healthcare (1/21)
Spotlight on IMPAQ & AIR
Individuals seeking care for opioid use disorder historically have encountered obstacles, including stigma and systemic barriers, and the global coronavirus epidemic added complexity, particularly around in-person treatment. Many providers have turned to telehealth during the public health emergency, and this service has the potential to expand access to opioid use disorder care. In an issue brief, experts from the American Institutes for Research (AIR) and IMPAQ explain federal and state actions on telehealth and opioid use disorder care, as well as the challenges that remain. (IMPAQ is an affiliate of AIR.)
Addressing Health Equity in 2021
As the vaccine rollout continues across the United States, data from 16 states show that Black Americans are underrepresented among vaccinated people. Fears about the safety of the vaccine, lack of access to information, and the focus on speed over equitable distribution all contribute to the racial disparities in COVID-19 vaccination rates. KHN (1/17)

  • These data are even more troubling given that only 22 states are tracking race and ethnicity information as they distribute vaccines within their communities, according to National Academy for State Health Policy. Reported gaps in vaccine data regarding race, ethnicity, and occupation make it difficult to ensure equitable vaccine distribution.
In an effort to reduce transmission of COVID-19, many communities across the United States are modifying or even canceling the annual street count of the nation’s unhoused population. Typically, conducting the count requires a large number of volunteers, who are often trained in person and then sent out to count and survey. Without this count, the United States lacks a key data point in its understanding of unhoused people. However, some advocates feel the pandemic could prompt more effective and comprehensive data collection methods to take root. NPR (1/18)
Individuals housed in U.S. Immigrations and Custom Enforcement (ICE) facilities experience a higher risk for COVID-19 infection than the general population and surrounding communities, according to a letter in JAMA Network Open. The authors of the letter, led by a University of Miami researcher, describe the data behind their conclusion, saying that because they relied on ICE data, the actual numbers of those housed in ICE facilities who contracted COVID-19 could be higher. In addition, they note reports of unsafe and unsanitary conditions and limited medical services in ICE facilities. CIDRAP (1/19)
Graphic of the Week
IMPAQ researchers have developed a dashboard to track the progress of COVID-19 clinical trials. The infographic below has been updated with our most recent data.
Upcoming Events, Trainings, & Webinars
Join the NIHCM Foundation in exploring challenges and solutions to the COVID-19 pandemic’s devastating impact on Black, Latino, and other communities of color. Speakers will address vaccine hesitancy, race-based treatment bias, and health plan’s efforts to improve access to culturally competent care. Register here.
The USC-Brookings Schaeffer Initiative for Health Policy is hosting a webinar discussing ways the federal government can work with states to improve the Medicaid program. The discussion will examine options to improve Medicaid eligibility rules, enrollment processes, and benefit designs, as well as approaches that could improve the quality and efficiency of the care delivered to Medicaid beneficiaries. Register here.
NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.
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