Week in Washington 041521

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington



  • Sequestration – President Biden signed into law a bill that extends the hiatus on Medicare sequestration until the end of the year.  However, the bill did not address sequestration in 2022, which could be 4% if Congress does not make changes to existing law.

  • Future Action- There continues to be debate among Democrats as to which health care policies are more important. Ultimately, there appears to be agreement that the next major bill should be deficit-neutral. In that environment, not every policy preference will be able to be met. The current debate seems to center around: extending the American Rescue Plan (which currently ends in 2022), expanding benefits to Medicare beneficiaries (e.g., dental/vision) as well as lowering the age of Medicare eligibility, and having a federal program to provide coverage to those uninsured who currently reside in states that have not expanded Medicaid). Consequently, it is likely that at least one of those policy priorities will not be included in the next legislative package.  

  • Hearings- The Senate had hearings for two of the top positions in HHS (Andrea Palm for Deputy Secretary of HHS) and Chiquita Brooks-Lasure (Administrator for CMS). The expectation is both will be confirmed soon.


  • Hospitalizations- Unfortunately, COVID-related hospitalizations have begun to increase in about 38 states. There is less of a correlation between cases, hospitalizations, and deaths due to vaccines, but despite vaccine efforts, hospitalization rates are increasing.

  • Vaccine hesitancy – The Census’ household Pulse Survey has a good tracker on vaccination hesitancy by state. In the coming weeks, vaccine numbers will be more of a function of demand than supply.


  • MLR Rebates- KFF released their estimates on what 2021 MLR rebates will be. Based on preliminary data, they estimate that insurers will issue about $2.1 billion in MLR rebates, of which the individual market accounts for $1.5 billion. The $2.1 billion is a decrease of about $400 million from last year.

  • SEP Numbers – Wakely released an analysis on SEP enrollment data released by HHS on the Healthcare.gov states. Wakely found that SEP enrollment was particularly up in the South and (relatedly) in states that have not expanded Medicaid.


  • Illinois received approval this week from CMS on their waiver to extend Medicaid coverage of women postpartum for one year. The approval means that women with incomes up to 208% can stay on Medicaid for up to one year after birth. The US has particularly high maternal mortality rates compared to the rest of the Developed world, which this waiver attempts to address. 

Research You can Use

Previous editions: 

4/08/2021: Week in Washington

3/25/2021: Week in Washington

3/18/2021: Week in Washington

3/11/2021: Week in Washington



3/04/2021: Week in Washington

2/25/2021: Week in Washington

2/18/2021: Week in Washington

2/11/2021: Week in Washington

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