Latest funding deal sidesteps fiscal cliff

The Centers for Medicare & Medicaid Services could have a broader mission under President-Elect Joe Biden’s administration in order to meet the many significant changes he’s eyeing in healthcare, according to a new analysis.

The report from the Kaiser Family Foundation noted there are more than 50 potential health policy administrative actions that Biden could take, based on campaign pledges. Cumulatively, those agenda items would impact every dimension of the healthcare system. 

For the long-term care sector, potential actions include a possible restoration of mandatory penalties for nursing facilities that violate federal quality standards, which would be a reversal from the Trump administration. The incoming administration also could attempt to increase nursing home staffing and oversight, and advance policies that strengthen home- and community-based services.

Many of Biden’s pledges seek to address Medicare, Medicaid expansion, funding and access to healthcare, which would fall under CMS’ scope and “virtually every dimension of the health care system.”  

The KFF analysis noted that means CMS could be called on to “much more proactive role harkening back to its formative days in the Carter administration when it was called the Health Care Financing Administration (HCFA).”

“Then HCFA viewed its mission as using its purchasing power to drive change throughout the health care system,” KFF President and CEO Drew Altman explained. “Its name was changed to CMS in 2001 by Republican Health and Human Services (HHS) Secretary Tommy Thompson to signal that the agency would be less aggressive and more responsive to states and providers, in keeping with a more conservative view of the role of the federal government.” 

Altman added that the agency will likely be asked to use demonstration and waiver authorities to accomplish smaller scale items that can’t be completed through Congress. 

“With its huge role and budget, it may be time for CMS to have a new name that signals a broader purpose, if only to instill a clearer sense of mission in the agency and help it attract the talent it will need in the future (a return to its original name would not be a bad choice, nor would Health Security Administration),” Altman speculated. 

“With the ability to move the health system every time it sneezes, at the right opportunity in the future it may also make sense to consider making CMS and the vast federal health financing enterprise it oversees a separate cabinet agency,” he added.