In many ways 2022 is starting off just like 2021, with COVID-19 dominating our lives and health care policy taking centerstage in front of a gridlocked Congress.  And just like last year, Chris Jennings and Doug Badger return to Hospitals In Focus to prognosticate on the upcoming year in health policy. Coming from each side of the political spectrum, the two long-time health policy wonks discuss with Chip how the Biden administration has handled the COVID crisis. What did they get right and where do they need to course correct? The three also examine the seemingly new role of the Supreme Court in the role of legislating in a divided Washington and what this could mean for health care policy.

Chip started by asking Jennings about the Biden Administration’s response to the pandemic so far and what we need to do going forward.

“The one thing that we do need to do is make sure that we’re better positioned in the future for any new pandemic. We need to shift from the acute interventions, which we are presently in the middle of, to longer term strategies that ensure we have adequate production and availability of PPE, of testing, of all the therapeutics and vaccines that we will need going forward,” Jennings said. “We still need to have significant investments in our public health infrastructure. This has exposed many, many vulnerabilities of our healthcare system.”

Doug Badger and Chip discussed the importance of health care for Republicans during an election year, and if they would keep talking about repealing and replacing the ACA.

“Republicans in Congress are much more comfortable talking about taxes, trade, national defense, national security, inflation and other sorts of things – than they are about health care. At the same time on the outside – the medical industry, insurance companies, hospitals, doctors, and others have sort of made peace with the ACA. That industry, by and large, supported its passage in 2010, opposed this repeal in 2017, and supported its temporary expansion last year…So Republicans in Congress can see the writing on the wall that if they challenge the status quo in any meaningful way, they’re going to face fairly considerable headwinds,” said Badger.

Both also addressed the growing importance of the Supreme Court when it comes to implementing health policy.  

“I think it’s quite clear that the power has shifted to the executive branch and then to the Supreme Court and away from Congress. What I think might happen is Congress, particularly Democrats in Congress, will have to be much more careful about how they draft language,” said Jennings. “They have to be more explicit, and they’re going to also have to look at past interpretations of the Supreme court about how they might review and adjudicate policies that the Congress passes. And I can tell you right now, that is part of the process that Congress is considering even for the most recent Build Back Better legislation.”

Badger added that, “It strikes me that the Chief Justice is always looking for some way to find a pathway he can steer the court that sort of splits the difference and doesn’t antagonize one side or the other too much. He sees that, I believe, as preserving the Court’s authority, the esteem in which people hold the Supreme Court. But the problem is it involves the judicial branch in a form of legislating to the extent that they are green lighting agency actions that clearly are not authorized by law.”

You can listen to the complete discussion here.

Our Guests:

Chris Jennings has spent decades working in the White House, Congress and private sector. He served in both the Clinton and Obama White Houses as Senior Advisor to the President for Health Policy and helped pass, enact and implement the ACA, Children’s Health Insurance Program (CHIP) and numerous other health reforms.

Doug Badger has been in public policy for many decades serving as a policy advisor to the White House, U.S. Senate, Department of HHS and the SSA. Doug worked in the Bush (43) administration and developed the administration’s proposal for adding prescription drug coverage to Medicare. He also represented the White House in negotiations with Congress that resulted in the enactment of the Medicare Modernization Act.