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EO 13997Executive OrderBiden · D

Executive Order 13997

Improving and Expanding Access to Care and Treatments for COVID-19

This executive order directs federal agencies to accelerate COVID-19 treatment development, expand healthcare system capacity through targeted surge assistance to long-term care facilities, and improve access to affordable care by evaluating insurance coverage programs and establishing production targets for therapeutics. It emphasizes supporting rural hospitals, historically underrepresented clinical trial populations, and patients with long-term COVID effects.

Federal Register Open PDF 86 FR 7201

Impact dates

  1. HHS Secretary to issue workforce capacity recommendations

  2. HHS Secretary to evaluate COVID-19 Uninsured Program and insurance coverage programs

  3. Agencies to provide targeted surge assistance to critical care and long-term care facilities

Key directives

  • HHS Secretary to develop plan for supporting large-scale randomized trials and optimal clinical management strategies for COVID-19 treatments
  • HHS Secretary to develop plan for research in rural hospitals and on long-term COVID health impacts, consulting non-governmental partners
  • HHS Secretary to consider steps ensuring historically underrepresented populations in clinical trials
  • Defense, HHS, VA Secretaries and other agency heads to provide targeted surge assistance to critical care and long-term care facilities
  • COVID-19 Response Coordinator to review federal facility needs and develop recommendations for military, veterans, and Tribal nations
  • HHS Secretary to promptly issue workforce capacity recommendations to States and providers
  • HHS to expand access to programs for long-term COVID recovery through HRSA and SAMHSA
  • Defense, HHS, VA Secretaries to establish production, allocation, and distribution targets for COVID-19 treatments
  • Defense, HHS, VA Secretaries to consider prioritizing investments in readily administered, scalable therapeutics
  • HHS Secretary to identify barriers to effective and equitable use of existing treatments and support State/local/Tribal/territorial authorities
  • HHS Secretary to promptly evaluate COVID-19 Uninsured Program and take steps to promote access for uninsured
  • HHS Secretary to evaluate Medicare, Medicaid, group health plans, and insurance issuers for COVID-19 treatment coverage

Who is ordered

Timeline

Immediate

  • Secretary of HHS to promptly issue workforce capacity recommendations
  • Secretary of HHS to promptly evaluate COVID-19 Uninsured Program and insurance coverage programs
  • Agencies to provide targeted surge assistance to critical care and long-term care facilities promptly as appropriate

Near term (90d)

  • Development of plans for supporting COVID-19 treatment studies
  • Development of plan for rural hospital and long-term COVID research
  • Review of federal facility needs and recommendations for supporting military, veterans, and Tribal nations
  • Establishment of production, allocation, and distribution targets for COVID-19 treatments

Long term

  • Implementation of expanded access to programs for long-term COVID health needs
  • Potential scaling of readily administered therapeutics through prioritized investments
  • Improved clinical trial inclusion of historically underrepresented populations

Risks & tensions

  • Multiple directives use 'as appropriate and consistent with applicable law' and 'subject to availability of appropriations' (Sec. 5(b)), creating uncertainty about binding force
  • No hard calendar deadlines specified; 'promptly' is vague and unenforceable
  • Clinical trial inclusion for historically underrepresented populations uses 'consider steps'—weak hortatory language
  • Therapeutic production targets require interagency coordination (Defense, HHS, VA) which may slow implementation
  • Rural research plan depends on non-governmental partner consultation, adding coordination complexity
  • Insurance coverage evaluation (Sec. 4(c)(ii)) may conflict with state regulatory authority and private insurer discretion
Executive Order 13997: Improving and Expanding Access to Care and Treatments for COVID-19 · Executive Orders