On his first days in office, President Joe Biden is expected to sign a flurry of executive actions, some of which will reverse decisions made by his predecessor, President Donald Trump. The first few Biden Administration executive orders will focus on the COVID-19 pandemic, climate change and addressing racial inequality.

Beyond the immediate actions reflected in the fact sheet, we anticipate additional healthcare executive orders on Jan. 28 for Medicaid and the Affordable Care Act (ACA) that take steps to strengthen Medicaid and initiate an open enrollment period under the ACA, as well as an order that rescinds the Mexico City policy and disavows the "Geneva Declaration" (a multilateral anti-abortion declaration signed by the Trump Administration).

Below are some of the initial actions announced that would affect health initiatives or regulations:

COVID-19

• Issue a "100 Days Masking Challenge" asking Americans to wear masks for 100 days
• Require "masks and physical distancing in all federal buildings, on all federal lands, and by federal employees and contractors"
• Request the U.S. Department of Health and Human Services (HHS) "to engage with state, local, Tribal, and territorial officials to implement masking, physical distancing, and other [Centers for Disease Control and Prevention (CDC)] public measures to stop the spread of COVID-19"
• Re-engage with the World Health Organization (WHO), including: 1) participation in the WHO Executive Board meeting "that is ongoing this week," and 2) work to "strengthen and reform the organization, support the COVID-19 health and humanitarian response, and advance global health and health security"
• Create the position of COVID-19 Response Coordinator, who will report directly to the president and be responsible for coordinating all elements of the COVID-19 response across government, including managing efforts to produce, supply, and distribute personal protective equipment, vaccines, and tests"
• Restore the National Security Council (NSC) "Directorate for Global Health Security and Biodefense to focus on domestic and global biological threats, play a critical role in stopping the COVID-19 pandemic, and prevent future biological catastrophes"

Racial Equity

• Sign an Executive Order "to advance racial equity," including but not limited to directing all federal agencies to conduct "a baseline review of the state of equity within their agency and deliver an action plan within 200 days to address unequal barriers to opportunity in agency policies and programs"
• The Executive Order will define equity as the "consistent and systematic fair, just, and impartial treatment of all individuals, including individuals who belong to underserved communities, such as Black, Latino, Indigenous and Native American persons, Asian Americans and Pacific Islanders, and other persons of color; LGBTQ+ persons; people with disabilities; religious minorities, persons who live in rural areas; and persons otherwise affected by persistent poverty or inequality."

Regulatory Process

• Issue a Presidential Memorandum "withdrawing the Trump Administration's regulatory process executive orders," and direct the Office of Management and Budget to develop recommendations to improve and modernize regulatory review, including the creation of a process to advance regulations that meet certain standards, including promoting "public health and safety"
• Issue a "regulatory freeze memo that will pause any new regulations from moving forward and give the incoming administration an opportunity to review any regulations that the Trump Administration tried to finalize in its last days" (Note that in the last few days there have been the publication of the Benefits and Payment Parameters (BPP) final rule and approval of the Tennessee 1115 Medicaid block grant waiver.)

For more information about what to expect for healthcare policy under the Democratic-controlled government, see the Holland & Knight alert, "Healthcare Policy Outlook with a Democratic-Controlled Senate," Jan. 20, 2021.