The result of the presidential election will no doubt have profound implications for public health. We can expect to see new leadership in most if not all the agencies under the US Department of Health and Human Services including CDC, HRSA, CMS, FDA etc. Those agencies have a great deal of latitude in the decisions they make and can change their regulations (CFR’s)… although changing regulations takes a lot more time than simple policy changes.
Congress may be split between a House controlled by Democrats and a Senate controlled by Republicans (pending Senate run-off elections in Georgia). If there is a split, the we’re unlikely to see major public health legislation passed but we will see dramatically different decisions being made by the various federal agencies. We can also expect to see a series of Executive Orders issued in mid-January that will have implications for public health and the response to the pandemic.
The transition to the new administration will be happening over the next 72 days. Transitions are always a bit tumultuous and this one will be particularly so because of the pandemic. For example, the FDA will be making critical decisions about the safety and efficacy of the various SARS CoV2 vaccines during the transition period. The CDC is expected to be developing guidance for the prioritization of the early vaccine doses. Several of the HHS agencies will be working on plans to deploy the vaccines.
Dr. Fauci is in a particularly interesting position. As the most credible national voice for COVID public health policy he must be thinking about whether he can be more useful as a member of the existing administration or whether he can be more valuable if he were to retire from his position at the NIH (at least temporarily) and work with the incoming administration’s transition team.
At our last Public Health Policy Committee meeting we discussed developing a more aggressive public health policy agenda for the upcoming legislative session in anticipation of either the State House or Senate flipping to Democratic control.
As it turns out, it looks like the Democrats will remain in the minority in both chambers again. We’ll continue to think through our policy agenda. In the mean-time, here’s the policy agenda from 2020: 2020 Legislative Session Priorities (ppt).