We can say that 2020 was a year of grief, loss, and a long-overdue account of the U.S.’s racial injustice history. But the year ended on a hopeful sign: in the final weeks of the year, the Food and Drug Administration approved two COVID-19 vaccines, and the American public’s immunization started.

The forthcoming Biden–Harris administration has pledged to present the federal pandemic leadership that has been urgently needed since COVID-19 emerged. The administration also brings revived hope for expanding access to affordable health care, important to control the pandemic, and rebuilding the economy.

COVID-19 pandemic will assist bring a sense of normalcy back to the country, but not till the second half of the year 2021 when ample proportion of the population has accepted the vaccine. We pray that Congress and the new administration utilize this opportunity to shore up the nation’s public health foundation and invest in the tools and resources to marshal a more prosperous federal response in the future.

As a consequence of COVID-19, state policymakers are fighting with increased demand for health assistance and lower-than-expected revenues. These factors could endanger Medicaid coverage gains made over the past decade. The states require federal support to respond to and recover from COVID-19 and stop further coverage. Congress could produce targeted state funds in future COVID relief bills, and the administration could partner with state leaders to guarantee states have the resources, flexibility, and tools to meet objections.

The racial and ethnic differences exposed by COVID-19 have energized the health sector and policymakers to discuss health equity. Aided by strong public sentiment, the new administration will take on health equity and social justice with dedication and well-enhanced policy proposals. Congress can support the administration in these purposes by protecting and expanding coverage for people of color, creating a safety-net institutions that have exhibited the brunt of the pandemic, and requiring that health care providers measure and lessen disparities in care affecting their patients.

Since the Affordable Care Act (ACA) became law more than a decade ago, the U.S. health system has made important development toward value-based care. The pandemic will strengthen the provider interest in payment models that boost value-based care, in part because such models also defend against damages in the event of dramatic declines in volume like those confronted during the pandemic. Value-based care makes room for innovation at the frontlines — greater coordination of care among providers, developed adoption of virtual care, and home-based care, leading to better consequences and greater efficiency. The march toward value and new payment models will need continued attention from policymakers, investment by provider systems, and accurate evaluation. With guidance from a panel of experts, the Commonwealth Fund’s Task Force report laid out a general strategy to move in that direction.

Though national health spending directed somewhat in 2020, costs remain a pressing problem that will need action in 2021. The Congressional Budget Office foretells that the Medicare Part A Trust Fund, which pays for hospital stays for beneficiaries, will become unbalanced as soon as 2024. The incoming Secretary of Health and Human Services can also serve with Congress to address health care industry consolidation that has directed to a lack of competition and higher rates for both public and private payers in many U.S. markets. Excessive drug prices also remain a huge burden for American consumers, and renewed attempts to revive reforms in drug pricing policy.

As we enter 2021 on a hopeful note, with a different administration and Congress all set to make progress in improving U.S. health system, the Commonwealth Fund stands ready to support public and private actors who share the goal of rendering affordable quality health care to all. We are particularly focused on people who have been denied equal access to the vital care our health system is so capable of affording.