After a tumultuous four days, Joe Biden crossed the electoral college threshold to become the 46th President of the United States, a result that the Trump Campaign is challenging with recounts and litigation in several states. As of this writing, control of the Senate is still unclear and although odds currently favor Democrats to retain the House, the votes are still coming in. Regardless of which party ekes out a Senate win, one thing is clear: it will lead with a razor-thin margin. If, after Congress is sworn in on January 3, the Senate remains in Republican hands and the Democrats control the House, prospects for major health reform legislation during the next two years will be slim—putting administrative actions and action in the states at center stage.
As the Biden transition team prepares to hit the ground running on Inauguration Day (January 20), the Trump Administration will sprint to the finish line, spending its final months promulgating significant regulatory and waiver actions to close out its policy agenda and, possibly, make it harder for the incoming Biden Administration to pursue its own objectives.
While President-elect Biden may seek to unwind some of these actions in his first days in office, new rulemaking will be necessary to change direction on some policy priorities, and it will take time for the President to appoint and for the Senate to confirm new leaders in the Department of Health and Human Services (HHS).
Among a host of near-term priorities for the new Administration, COVID-19 and its impact on the economy will be at the forefront, potentially delaying action on other healthcare issues on the transition agenda.
