For a bunch of incompetents when it comes to actual governing, the Trump administration has been remarkably creative and effective when it comes to destruction. It's like they've trawled through every aspect of every department looking for fires to set, policies to dismantle—or enact—to cause the most damage possible. If anything, Trump's loss has made them even more determined to just blow it all to smithereens and to make things as difficult and screwed up for the incoming Biden administration as possible. If it can needlessly harm a maximum of people, it's even better.
Take, for example, a new proposed rule Health and Human Services (HHS) is rushing to finalize that would force HHS staff—under Biden—to assess almost every HHS regulation and determine whether it should be continued, amended, or rescinded. If the assessment doesn't happen, the regulations automatically expire. Which is why they call it “Securing Updated and Necessary Statutory Evaluations Timely” (SUNSET). What this would do in practical terms is pull legions of staff from running Medicare and Medicaid and Obamacare and all the other programs—in the middle of a pandemic when there are real emergencies.
It's probably no accident that they're trying to promulgate this rule exactly 10 years after the Affordable Care Act, with its raft of regulations, was enacted. Because the automatic expiration happens at 10 years unless the assessment is done. HHS estimates that in the first two years it would have to assess more than 2,400 rules at a cost of $26 million over 10 years. It would require 90 full-time staff to complete. And, as Jessica Schubel at the Center on Budget and Policy Priorities argues, it would "distract the Biden Administration from critically important priorities that it must address, especially COVID-19. It would disrupt work on program operations and force the Administration to delay adopting its health care priorities because it needed to redirect staff to review existing regulations."
The work would have to be done because the regulations in question are governing how programs like Medicaid, for example, work and how states implement and run their programs. It’s an asinine rule meant to do nothing but sabotage the Biden administration. It's not even remotely necessary because the department already has review processes in place, processes that would be disrupted for regulations that need to be considered because staff would be pulled off doing unrelated and unnecessary reviews.
Just for example, the Food and Drug Administration (FDA) issues hundreds of regulations every year. Biopharma trade publication Biocentury spoke with a former senior FDA official who said that complying with the rule would "paralyze" the FDA. Coleen Klasmeier, formerly an attorney in the FDA's Office of the Chief Counsel, blasted the administration for making the announcement the very day after the election, with Trump refusing to concede. "First, it takes a particularly generous amount of tone deafness to do this today," she told Biocentury. "Second, it will paradoxically increase regulatory complexity and disrupt settled expectations with uncertain benefits for small entities. Third, it would harm the public health for regulations to automatically sunset, which seems likely given the burdens associated with performing the review."
HHS Chief of Staff Brian Harrison was clear about why they pushed this. "The reason we're doing this now is because we at the department are trying to go as fast as we can in hopes of finalizing the rule before the end of [Trump’s] first term." In terms of fucking absolutely everything up, it was a win-win for Team Trump. They could either upend basically the entire healthcare system (when the Supreme Court seems unlikely to choose to do so by tossing Obamacare) under Trump, or make one more mess for Biden to have to untangle in his first weeks in office.
Instead of actually working on the coronavirus pandemic, this is what Trump's HHS team is spending time and energy on: cooking up more bombs. Hopefully there are enough career officials in the government to slow walk this and prevent it from becoming final.
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