Introduction: Health Policy and the Biden Administration.

Abstract

Joe Biden takes office as president of the United States in the midst of a global pandemic, immense economic and social dislocation, recurrent reminders of racial injustice, acrimonious partisan divisions, and disquieting threats to American democracy. After the tumult of the Trump years, Biden will try to restore normalcy to Washington. But he comes to the presidency at a time that is anything but normal, with myriad challenges that will immediately confront his administration. Health policy will be central to the new administration. As Biden takes office, the staggering case count and death toll from COVID-19 continue to mount. The administration must figure out how to ramp up an unprecedented program of mass vaccination against COVID-19 while encouraging the maintenance of social distancing and other public health measures in a nation that is politically divided and fatigued by the pandemic. It also needs to develop a coordinated national COVID-19 strategy that overcomes the fragmentation of American federalism. And it must prepare for the next pandemic. Yet the COVID-19 public health emergency is only one issue on the administration’s health policy agenda. The pandemic has once again exposed the cavernous holes in America’s byzantine, illogical, expensive, and inequitable health insurance arrangements. The uninsured population is on the rise again, driven upward by Trump administration policies that eroded access to insurance and the economic fallout of COVID-19 that buffeted employer-sponsored insurance. The Affordable Care Act (ACA), now more than a decade old, is sorely in need of repairs to make insurance