“The first 100 days,” a phrase coined by President Franklin Delano Roosevelt in 1933, is an opportunity for a new administration to outline its early accomplishments and set a tone of reassurance. Under that philosophy, the Biden-Harrison transition team issued a series of announcements and nominations beginning in November 2020 to set a tenor and provide insight on the first phase of the new presidency.

A Transition Focused on Health Care

Setting the right tone is essential for a smooth transition. Several days after the election was called, President-Elect Joe Biden spoke to bridge some of the division.

“Americans have called upon us to marshal the forces of decency, the forces of fairness, the forces of science, and the forces of hope in the great battles of our time. The battle to control the virus. The battle to build prosperity. The battle to secure your family’s health care. The battle to achieve racial justice and root out systemic racism in this country,” Biden said in a video to the nation.

The team’s first action was to form a COVID-19 advisory board. With health and medical professionals who served in previous Republican and Democratic administrations, Biden outlined his plan.

“Dealing with the coronavirus pandemic is one of the most important battles our administration will face, and I will be informed by science and by experts. The advisory board will help shape my approach to managing the surge in reported infections; ensuring vaccines are safe, effective, and distributed efficiently, equitably, and free; and protecting at-risk populations,” he said.

On December 3, 2020, Biden asked the country to join him in a pledge: “Just 100 days to mask, not forever. One hundred days. And I think we'll see a significant reduction.”

Health Policy Priorities

The first 100 days offer the Biden-Harris administration a critical opportunity to build on campaign promises, particularly in health care, which has a number of priorities that a majority of Americans safeguard. These include coverage for preexisting conditions, insuring dependent children, and lowering prescription medications. Biden must work across party lines in the U.S. Congress to achieve those goals, but doing so would solidify his legacy during an important phase of his presidency.

He will make appointments for Department of Health and Human Services leaders, such as the assistant secretary of health, U.S. surgeon general, and director of the National Institutes of Health. The Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and the U.S. Food and Drug Administration will also get administration appointments. All candidates require U.S. Senate confirmation, so qualified names will be vetted in advance. 

President-Elect Biden already plans to use the authority of presidential executive orders (EOs) to implement his agenda with a divided Congress, saying that he will reverse decisions that withdraw the United States from some global pacts. In particular, look for immediate EOs reinstating the country in the Paris Climate Accord and World Health Organization (WHO). On July 7, 2020, Biden tweeted, “Americans are safer when America is engaged in strengthening global health. On my first day as President, I will rejoin the @WHO and restore our leadership on the world stage.”

The administration and its advisors have also outlined bolder actions on health care, including a public purchase option similar to Medicare for those without coverage, an end to surprise billing for out-of-network providers, lower drug costs, and increased access to generics and biotech.

The Future of Affordable Care

Finally, in November 2020, the U.S. Supreme Court heard oral arguments on the Patient Protection and Affordable Care Act (ACA). In the case of California v. Texas, the law’s validity rested on two points:

  • Is ACA’s individual mandate, which now has no financial penalty for not buying health insurance, constitutional?
  • If the individual mandate is unconstitutional, can it be removed (known as severability) from the rest of ACA?

As the court deliberates on the case’s merits and implications, the Biden administration will build contingency plans to help Americans maintain access to care. The court’s ruling will be the cornerstone of the next phase in any discussion of federal healthcare legislation.

ONS Perspective

ONS has a long, strong history with President-Elect Joe Biden. Many ONS members have worked with the Cancer Moonshot Initiative, literally having a seat at the table with the president-elect. The Society is communicating with the incoming administration on relevant issues in which oncology nurses can be a trusted resource. For ONS, advocacy is a priority for the first 100 days—and well beyond.