President Biden spoke about his American Families Plan (AFP) at a joint congressional session this week. Biden campaigned for a public health insurance option, lowered Medicare eligibility ages, and lowered prescription drug prices, but all of them were missing from his major health package. Biden spoke about a variety of health policy priorities that progressives demand, even if he paid lip service to them.

When Biden signed the American Rescue Plan (ARP) in March, it was seen as a down payment on Biden’s health agenda. The legislation contained several essentials Health initiatives and a lot of health care spending, but the main progressive goals have been left out. Health policy should then move into the second package, the generally defined infrastructure package. This package, which is still embryonic, has now been divided into two parts. Health care, except for a large one investment in long-term home care, has been pushed out of the American Jobs Plan and pushed to the AFP. Many congressional progressives expected Biden to enforce their extreme drug pricing laws. HR 3, as a source of income in the AFP, but it shouldn’t be. The AFP largely eschews health policywith an emphasis on tax changes, childcare, education and paid leave. The one major health policy – and it’s important to be fair – is a permanent extension of the changes the ARP has made to the Affordable Care Act (ACA) subsidy framework for health insurance.

In fact, it means the ARP really was the high water mark for Biden’s health boost this year. That is surprising to say the least. Biden urged Congress to take action on various health policy priorities this year – drug prices in particular – but not as part of a reconciliation bill that Democrats hope to pass. There are two challenges in passing other laws, especially for HR 3.

First there is the congress calendar. If the American employment plan is drawn up with reconciliation – necessary to avoid a filibuster in the Senate – Congress must first attempt a never-before-seen maneuver, amend the 2021 budget resolution and create new reconciliation directives. This will not be a full budget process, but it will require both the House and Senate to debate and pass a budget change, including a lengthy Senate amendment process, before work on the Reconciliation Act can begin. Once the House has passed the AJP, it must be reviewed by the Senate MP to see if any provisions violate the rules of reconciliation. If the Senate is trying to pass a non-partisan infrastructure bill at the same time, it may take even more time. Then Congress will have to pass a budget resolution for 2022 to get a third set of reconciliation orders. At the same time, Congress must fund the government before the end of September and likely raise the debt ceiling. In other words, it’s not entirely clear that Congress can get the AFP passed before the end of the year, let alone a standalone drug price bill or lowering the Medicare age.

The second problem, of course, is that HR 3 cannot avoid a filibuster in the SenateSo if it’s not part of a reconciliation package, it will be dead by the time it arrives in the Senate, even if the House Democrats can muster enough votes to pass it. IIt is possible, even likely, that some Congressional Democrats will attempt to include the provisions of HR 3 in the AFP reconciliation package anyway, but by leaving it out of his proposal, Biden has given cover to moderate members of the House and Senate who can Be dissatisfied with HR 3’s extreme guidelines to turn down the effort. Ongoing hopes of dictating drug prices, lowering the Medicare age, and implementing a public option cannot fade outside of reconciliation – and in the case of the latter two, they may not be eligible for reconciliation – and Biden just has it much more difficult made one of them to involve them in reconciliation.

The upshot of all of this is that the improvements in ACA subsidies – temporarily in the ARP and permanent when the AFP becomes law – along with the proposed expansion of home health care could, certainly, be the sum of Biden’s health care agenda this year many will be left disappointed.

Chart Review: Advertising Expenses for the ACA Special Enrollment Period

Madeline VanHorn, Health and Social Policy Intern

The Biden Administration has a Special registration deadline (SEP) in response to the pandemic, Beginning February 15th and set on continue until August 15th. Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) have started Advertising campaign Raising awareness of the SEP, including digital and radio advertising, and email and text communications. In January before the start of the SEP, CMS $ agreed50 million for advertising. Another $50 million The awareness campaign was announced on April 15th, which means the total funding for these campaigns is $ 100 million. In the period from February 15 to March 15, 528,000 plan selections were made –compared to 209,000 plan selections in 2020 when there was no blanket SEP and instead people could only enroll through a SEP if their circumstances allowed. Given the amount that is being spent on advertising, this registration comes in at nearly $ 95 per plan selection. Below this sum, the amount that was spent on advertising during the open registration is compared. $ 10 million. By comparison, the United States stopped by during open enrollment for the 2021 plan year 8.2 million The plan selection and the advertising cost per plan selection was $ 1.21.

Source: Centers for Medicare and Medicaid Services

Tracking COVID-19 Cases and Vaccinations

Christopher Holt, Director of Health Policy

To keep track of the progress of the vaccinations, the weekly checkup creates the most relevant statistics for the week, with the seven-day period ending on Wednesday of each week.

Week ends: New COVID-19 cases:
7 day average
Newly fully vaccinated:
7 day average
Daily deaths:
7 day average

April 28, 2021




April 21, 2021




April 14, 2021




April 7, 2021




March 31, 2021




March 24, 2021




March 17, 2021




March 10, 2021




March 3, 2021




February 24, 2021




February 17, 2021




February 10, 2021




February 3, 2021




January 27, 2021




Sources: Centers for Disease Control and Prevention Trends in COVID-19 cases and deaths in the United States, and Trends in COVID-19 vaccination in the US

Note: The U.S. population is 330,233,976.

Worth a look

The hill: Democrats Push To Rise Drug Prices, Medicare Measures On Biden Plan

New York Times: How Pfizer makes its Covid-19 vaccine