Week in Washington 6182020

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


COVID Trends

This week there were two distinct COVID trends. The first is that the epidemic has shifted to new cases being located in the South and West as opposed to the Northeast and Midwest. The map below (red - cases increasing, green - cases decreasing, yellow - status quo) shows which states are showing changes in COVID patterns.

Figure from covidexitstrategy.org


The second major trend is that while cases have increased in the past week, the number of deaths have decreased. What explains this phenomenon? One likely explanation, as research from Vanderbilt was able to confirm for Tennessee, is that the risk-mix of those newly infected is much lower than it previously was. In other words, younger/healthier people are more likely to have COVID now relative to older/sicker people earlier in the pandemic.

Long-Term Costs for COVID

One of the many unknowns is the long-term implications and costs associated with COVID. Currently the United Kingdom is estimating that of those hospitalized 45% will need ongoing care.  This could mean non-minor long-term effects of COVID.

Economic News

Weekly jobless claims were higher than expected this week with approximately 1.5 million jobless claims. While last week’s job’s numbers are promising, this week’s unemployment number does point to a current relative weakness in the economy.

You can track spending pattern changes, in near real time, – including healthcare spending – by state here.

State Budgets

State budgets have been particularly harmed by the ongoing pandemic. New research estimates that on average, state budgets are experiencing a 20% shortfall in revenue, including 10 states with over 30% shortfalls (New York being the projected worst with a 40% shortfall).


Congress is still debating about the next round of stimulus with July being the current target. In the meanwhile, the House is expected to vote and pass an “ACA 2.0”. While the bill is symbolic, i.e., has no chance at enactment in the current Congress, it does point to Democratic priorities. The bill will include provisions that would provide more funding for individual market subsidies and expand Medicaid up to 200% FPL (paywalled link).


CMS released a few rules this week:

  • An update to non-discrimination rules (i.e., Section 1557). This update will face litigation.
  • CMS also released a new  proposed rule that increases state flexibility around their Medicaid programs and drug utilization review. 

Happy Juneteenth!

Previous editions: 

6/11/2020: Week in Washington

6/4/2020: Week in Washington

5/28/2020: Grim Milestone

5/21/2020: Week in Washington


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