An America-First Healthcare Plan, 62179-62186 [2020-21914]

Agencies

• Executive Office of the President

[Federal Register Volume 85, Number 191 (Thursday, October 1, 2020)]
[Presidential Documents]
[Pages 62179-62186]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-21914]



[[Page 62177]]

Vol. 85

Thursday,

No. 191

October 1, 2020

Part VI





The President





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Executive Order 13951--An America-First Healthcare Plan


                        Presidential Documents 



Federal Register / Vol. 85 , No. 191 / Thursday, October 1, 2020 / 
Presidential Documents

___________________________________________________________________

Title 3--
The President

[[Page 62179]]

                Executive Order 13951 of September 24, 2020

                
An America-First Healthcare Plan

                By the authority vested in me as President by the 
                Constitution and the laws of the United States of 
                America, it is hereby ordered as follows:

                Section 1. Purpose. Since January 20, 2017, my 
                Administration has been committed to the goal of 
                bringing great healthcare to the American people and 
                putting patients first. To that end, my Administration 
                has taken monumental steps to improve the efficiency 
                and quality of healthcare in the United States.

                    (a) My Administration has been committed to 
                restoring choice and control to the American patient.

                On December 22, 2017, I signed into law the repeal of 
                the burdensome individual-mandate penalty, liberating 
                millions of low-income Americans from a tax that 
                penalized them for not purchasing health-insurance 
                coverage they did not want or could not afford. Through 
                Executive Order 13813 of October 12, 2017 (Promoting 
                Healthcare Choice and Competition Across the United 
                States), my Administration has expanded coverage 
                options for millions of Americans in several ways. My 
                Administration increased the availability of renewable 
                short-term, limited-duration healthcare plans, 
                providing options that are up to 60 percent cheaper 
                than the least expensive alternatives under the Patient 
                Protection and Affordable Care Act (ACA) and are 
                projected to cover 500,000 individuals who would 
                otherwise be uninsured. My Administration expanded 
                health reimbursement arrangements, which have been 
                projected by the Department of the Treasury to reach 
                800,000 businesses and over 11 million employees and to 
                expand coverage to more than 800,000 individuals who 
                would otherwise be uninsured. My Administration also 
                issued a rule to increase the availability of 
                association health plans for small businesses, which, 
                upon implementation of the rule, are projected to cover 
                up to 400,000 previously uninsured individuals for on 
                average 30 percent less cost.

                As set forth in the Economic Report of the President 
                (February 2020), my Administration's expansion of 
                health savings accounts will further help millions of 
                Americans pay for health expenditures by allowing them 
                to save more of their own money free from Federal 
                taxation, and will especially help Americans with 
                chronic conditions who now have more flexibility to 
                enroll in plans that fit their complicated care needs 
                and can be paired with a tax-advantaged account.

                At the beginning of the current COVID-19 pandemic, my 
                Administration acted to dramatically increase the 
                accessibility and availability of telehealth services 
                for Medicare beneficiaries, enabling millions of 
                individuals to use these services. Pursuant to 
                Executive Order 13941 of August 3, 2020 (Improving 
                Rural Health and Telehealth Access), the Secretary of 
                Health and Human Services will make permanent many of 
                the new policies that improve the accessibility and 
                availability of telehealth services. In addition, 
                pursuant to that order, the Secretary of Health and 
                Human Services and the Secretary of Agriculture will 
                develop and implement a strategy to improve the 
                physical and communications healthcare infrastructure 
                available to rural Americans.

                Through our State Relief and Empowerment Waivers, my 
                Administration has given States additional health-
                insurance flexibility, which has expanded health-
                insurance coverage options for consumers and lowered 
                costs for patients. These waivers allow States to move 
                away from the ACA's rigid

[[Page 62180]]

                structure and are estimated to have lowered premiums by 
                approximately 11 percent in Wisconsin, 20 percent in 
                Minnesota, and 43 percent in Maryland. Due to actions 
                my Administration took, like the State Relief and 
                Empowerment Waivers, after years of dwindling choices 
                and escalating prices, plan options for consumers 
                increased and for 2019, for the first time ever, 
                benchmark premiums actually decreased on 
                Healthcare.gov. For 2020, the average benchmark premium 
                dropped by nearly 4 percent.

                After the prior Administration spent tens of billions 
                of dollars creating electronic health records systems 
                unable to accurately or effectively record and 
                communicate patient data, my Administration has paved 
                the way for a new wave of innovation to allow patients 
                to safely send their own medical records to care 
                providers of their choosing. My Patients over Paperwork 
                initiative has cut red tape for doctors and nurses so 
                they can spend more time with their patients, which the 
                Centers for Medicare and Medicaid Services (CMS) within 
                the Department of Health and Human Services (HHS) has 
                estimated to save over 40 million hours of wasted time 
                for providers and suppliers between 2017 and 2021.

                    (b) My Administration has been ceaseless in its 
                efforts to lower costs to make healthcare more 
                affordable for American patients.

                Under my tenure, prescription drugs saw their largest 
                annual price decrease in nearly half a century. For 
                three consecutive years, we have approved a record 
                number of generic drugs. The Council of Economic 
                Advisers has estimated that these approvals saved 
                patients $26 billion in the first 18 months of my 
                Administration alone. As part of the Further 
                Consolidated Appropriations Act, 2020, I signed into 
                law the Creating and Restoring Equal Access to 
                Equivalent Samples Act, which will pave the way for 
                even more generic drugs and is projected to save 
                taxpayers $3.3 billion from 2019 to 2029.

                CMS has acted to offer Medicare beneficiaries 
                prescription drug plans with the option of insulin 
                capped at $35 in out-of-pocket expenses for a 30-day 
                supply. We are also reducing Government payments to 
                overcharging hospitals participating in the 340B Drug 
                Pricing Program by instead paying rates that more 
                accurately reflect the hospitals' acquisition costs, 
                which CMS estimated would save Medicare beneficiaries 
                $320 million on copayments for drugs alone.

                As a result of Executive Order 13937 of July 24, 2020 
                (Access to Affordable Life-Saving Medications), low-
                income Americans who receive care from a federally 
                qualified health center will have access to insulin and 
                injectable epinephrine at prices lower than ever 
                before. Under Executive Order 13938 of July 24, 2020 
                (Increasing Drug Importation to Lower Prices for 
                American Patients), my Administration will be the first 
                to complete a rulemaking to authorize the safe 
                importation of certain lower-cost prescription drugs 
                from Canada. Pursuant to Executive Order 13939 of July 
                24, 2020 (Lowering Prices for Patients by Eliminating 
                Kickbacks to Middlemen), my Administration is taking 
                action to eliminate wasteful payments to middlemen by 
                passing drug discounts through to patients at the 
                pharmacy counter without increasing premiums for 
                beneficiaries or cost to Federal taxpayers. And my 
                Administration is taking action to ensure that Medicare 
                patients receive the lowest price that drug companies 
                offer comparable foreign nations through Executive 
                Order 13948 of September 13, 2020 (Lowering Drug Prices 
                by Putting America First).

                As part of the Further Consolidated Appropriations Act, 
                2020, I also signed into law the repeal of the medical 
                device tax, the annual fee on health-insurance 
                providers, and the ``Cadillac'' tax on certain 
                employer-sponsored health insurance, which threatened 
                to dramatically increase the cost of healthcare for 
                working families.

                My Administration is transforming the black-box 
                hospital and insurance pricing systems to be 
                transparent about price and quality. Regardless of 
                health-insurance coverage, two-thirds of adults in 
                America still worry about the threat of unexpected 
                medical bills. This fear is the result of a system

[[Page 62181]]

                under which individuals and employers are unable to see 
                how insurance companies, pharmacy benefit managers, 
                insurance brokers, and providers are or will be paid. 
                One major culprit is the practice of ``surprise 
                billing,'' in which a patient receives unexpected bills 
                at highly inflated prices from providers who are not 
                part of the patient's insurance network, even if the 
                patient was treated at a hospital that was part of the 
                patient's network. Patients can receive these bills 
                despite having no opportunity to select around an out-
                of-network provider in advance.

                On May 9, 2019, I announced four principles to guide 
                congressional efforts to prohibit exorbitant bills 
                resulting from patients' accidentally or unknowingly 
                receiving services from out-of-network physicians. 
                Unfortunately, the Congress has failed to act, and 
                patients remain vulnerable to surprise billing.

                In the absence of congressional action, my 
                Administration has already taken strong and decisive 
                action to make healthcare prices more transparent. On 
                June 24, 2019, I signed Executive Order 13877 
                (Improving Price and Quality Transparency in American 
                Healthcare to Put Patients First), directing certain 
                agencies--for the first time ever--to make sure 
                patients have access to meaningful price and quality 
                information prior to the delivery of care. Beginning 
                January 1, 2021, hospitals will be required to publish 
                their real price for every service, and publicly 
                display in a consumer-friendly, easy-to-understand 
                format the prices of at least 300 different common 
                services that are able to be shopped for in advance.

                We have also taken some concrete steps to eliminate 
                surprise out-of-network bills. For example, on April 
                10, 2020, my Administration required providers to 
                certify, as a condition of receiving supplemental 
                COVID-19 funding, that they would not seek to collect 
                out-of-pocket expenses from a patient for treatment 
                related to COVID-19 in an amount greater than what the 
                patient would have otherwise been required to pay for 
                care by an in-network provider. These initiatives have 
                made important progress, although additional efforts 
                are necessary.

                Not all hospitals allow for surprise bills. But many 
                do. Unfortunately, surprise billing has become 
                sufficiently pervasive that the fear of receiving a 
                surprise bill may dissuade patients from seeking 
                appropriate care. And research suggests a correlation 
                between hospitals that frequently allow surprise 
                billing and increases in hospital admissions and 
                imaging procedures, putting patients at risk of 
                receiving unnecessary services, which can lead to 
                physical harm and threatens the long-term financial 
                sustainability of Medicare.

                Efforts to limit surprise billing and increase the 
                number of providers participating in the same insurance 
                network as the hospital in which they work would 
                correspondingly streamline the ability of patients to 
                receive care and reduce time spent on billing disputes.

                On May 15, 2020, HHS released the Health Quality 
                Roadmap to empower patients to make fully informed 
                decisions about their healthcare by facilitating the 
                availability of appropriate and meaningful price and 
                quality information. These transformative actions will 
                arm patients with the tools to be active and effective 
                shoppers for healthcare services, enabling them to 
                identify high-value providers and services, and 
                ultimately place downward pressure on prices.

                My Administration has cracked down on waste, fraud, and 
                abuse that direct valuable taxpayer resources away from 
                those who need them most. My Administration implemented 
                a ``site neutral'' payment system between hospital 
                outpatient departments and physicians' offices, to 
                ensure Medicare beneficiaries are charged the same 
                price for the same service regardless of where it takes 
                place, which CMS estimates will save them approximately 
                $160 million in co-payments for 2020. We also changed 
                the rules to enable Government watchdogs to proactively 
                identify and stop perpetrators of fraud before money 
                goes out the door.

                    (c) My Administration has been dedicated to 
                providing better care for all Americans.

[[Page 62182]]

                This includes a steadfast commitment to always 
                protecting individuals with pre-existing conditions and 
                ensuring they have access to the high-quality 
                healthcare they deserve. No American should have to 
                risk going without health insurance based on a health 
                history that he or she cannot change.

                In an attempt to justify the ACA, the previous 
                Administration claimed that, absent action by the 
                Congress, up to 129 million (later updated to 133 
                million) non-elderly people with what it described as 
                pre-existing conditions were in danger of being denied 
                health-insurance coverage. According to the previous 
                Administration, however, only 2.7 percent of such 
                individuals actually gained access to health insurance 
                through the ACA, given existing laws and programs 
                already in place to cover them. For example, the Health 
                Insurance Portability and Accountability Act of 1996 
                has long protected individuals with pre-existing 
                conditions, including individuals covered by group 
                health plans and individuals who had such coverage but 
                lost it.

                The ACA produced multiple other failures. The average 
                insurance premium in the individual market more than 
                doubled from 2013 to 2017, and those who have not 
                received generous Federal subsidies have struggled to 
                maintain coverage. For those who have managed to 
                maintain coverage, many have experienced a substantial 
                rise in deductibles, limited choice of insurers, and 
                limited provider networks that exclude their doctors 
                and the facilities best suited to care for them.

                Additionally, approximately 30 million Americans remain 
                uninsured, notwithstanding the previous 
                Administration's promises that the ACA would address 
                this intractable problem. On top of these disappointing 
                results, Federal taxpayers and, unfortunately, future 
                generations of American workers, have been left with an 
                enormous bill. The ACA's Medicaid expansion and 
                subsidies for the individual market are projected by 
                the Congressional Budget Office to cost more than $1.8 
                trillion over the next decade.

                The ACA is neither the best nor the only way to ensure 
                that Americans who suffer from pre-existing conditions 
                have access to health-insurance coverage. I have agreed 
                with the States challenging the ACA, who have won in 
                the Federal district court and court of appeals, that 
                the ACA, as amended, exceeds the power of the Congress. 
                The ACA was flawed from its inception and should be 
                struck down. However, access to health insurance 
                despite underlying health conditions should be 
                maintained, even if the Supreme Court invalidates the 
                unconstitutional, and largely harmful, ACA.

                My Administration has always been committed to ensuring 
                that patients with pre-existing conditions can obtain 
                affordable healthcare, to lowering healthcare costs, to 
                improving quality of care, and to enabling individuals 
                to choose the healthcare that meets their needs. For 
                example, when the COVID-19 pandemic hit, my 
                Administration implemented a program to provide any 
                individual without health-insurance coverage access to 
                necessary COVID-19-related testing and treatment.

                My commitment to improving care across our country 
                expands vastly beyond the rules governing health 
                insurance. On July 10, 2019, I signed Executive Order 
                13879 (Advancing American Kidney Health) to improve 
                care for the hundreds of thousands of Americans 
                suffering from end-stage renal disease. Pursuant to 
                that order, my Administration launched a program to 
                encourage home dialysis and promote transplants for 
                patients, and expects to enroll approximately 120,000 
                Medicare beneficiaries with end-stage renal disease in 
                the program. We also have removed financial barriers to 
                living organ donation by adding additional financial 
                support for living donors, such as by reimbursing 
                expenses for lost wages, child care, and elder care. 
                HHS, together with the American Society of Nephrology, 
                issued two phases of awards through KidneyX's Redesign 
                Dialysis Price Competition to work toward the creation 
                of an artificial kidney.

                My Administration has taken unprecedented action to 
                improve the quality of and access to care for 
                individuals with HIV, as part of our goal of ending the 
                epidemic of HIV in the United States by 2030. HHS has 
                awarded

[[Page 62183]]

                at least $226 million to expand access to HIV care, 
                treatment, medication, and prevention services, focused 
                on 48 counties, Washington, DC, and San Juan, Puerto 
                Rico, where more than 50 percent of new HIV diagnoses 
                occurred in 2016 and 2017, as well as seven States with 
                a substantial rural HIV rate. We secured a historic 
                donation of a groundbreaking HIV preventive medication 
                that is available at no cost to eligible patients.

                My Administration has started a transformation in 
                healthcare in rural America. This includes a new 
                effort, pursuant to my directive in Executive Order 
                13941, to support small hospitals and health clinics in 
                rural communities in transitioning from volume-based 
                Medicare and Medicaid reimbursement, which has failed 
                rural communities that struggle with a lack of patient 
                volume, and toward value-based payment mechanisms that 
                are tailored to meet the needs of their communities. We 
                updated Medicare payment policies to address a problem 
                in the program's payment calculation that has 
                historically disadvantaged rural hospitals, and 
                released a Rural Action Plan to incorporate 
                recommendations from experts and leaders across the 
                Federal Government. We have also dedicated a special 
                focus on improving care offered through the Indian 
                Health Service (IHS) within HHS, including by creating 
                the Office of Quality, implementing an increase in 
                annual funding for IHS by $243 million from 2019 to 
                2020, and expanding nationwide IHS's successful Alaska 
                Community Health Aide Program.

                My Administration has additionally demonstrated an 
                incredible dedication to protecting and improving care 
                for those most in need, including senior citizens, 
                those with substance use disorders, and those to whom 
                our Nation owes the greatest debt: our veterans.

                I have protected the viability of the Medicare program. 
                For example, on February 9, 2018, I signed into law the 
                repeal of the Independent Payment Advisory Board, which 
                would have been a group of unelected bureaucrats 
                created by the ACA, designed to be insulated from the 
                will of America's elected leaders for the purpose of 
                cutting the spending of this important program. On 
                October 3, 2019, I signed Executive Order 13890 
                (Protecting and Improving Medicare for Our Nation's 
                Seniors), to modernize the Medicare program and 
                continue its viability. According to CMS estimates, 
                seniors have saved $2.65 billion in lower Medicare 
                premiums under my Administration while benefiting from 
                more choices. For example, the average monthly Medicare 
                Advantage premium has declined an estimated 28 percent 
                since 2017, and Medicare Advantage has included about 
                1,200 more plan options since 2018. New Medicare 
                Advantage supplemental benefits have helped seniors 
                stay safe in their homes, improved respite care for 
                caregivers, and provided transportation, more in-home 
                support services and assistance, and non-opioid pain 
                management alternatives like therapeutic massages. 
                Medicare Part D premiums are at their lowest level in 
                their history, with the average basic premium declining 
                13.5 percent since 2016.

                My Administration has directed unprecedented attention 
                on the substance use disorder epidemic, with a focus on 
                reducing overdose deaths from prescription opioids and 
                the deadly synthetic opioid fentanyl. On October 24, 
                2018, I signed the Substance Use-Disorder Prevention 
                that Promotes Opioid Recovery and Treatment for 
                Patients and Communities Act, enabling the expenditure 
                of billions of dollars of funding for important 
                programs to support prevention and recovery. My 
                Administration has provided approximately $22.5 billion 
                from 2017 to 2020 to address the opioid crisis and 
                improve access to prevention, treatment, and recovery 
                services. We saw a 34 percent decrease in total opioids 
                dispensed monthly by pharmacies between 2017 and 2019, 
                an approximate increase of 64 percent in the number of 
                Americans who receive medication-assisted treatment for 
                opioid use disorder since 2016, and a 484 percent 
                increase in naloxone prescriptions since 2017. Data 
                show that drug overdose deaths fell nationwide for the 
                first time in decades between 2017 and 2018, with many 
                of the hardest-hit States leading the way.

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                Improving care for our Nation's veterans has been a 
                priority since the beginning of my Administration. On 
                June 6, 2018, I signed the VA Maintaining Internal 
                Systems and Strengthening Integrated Outside Networks 
                (MISSION) Act of 2018, which authorized billions of 
                dollars to improve options for veterans to receive care 
                outside of Department of Veterans Affairs (VA) 
                healthcare providers. Since taking effect, the VA 
                estimates that more than 2.4 million veterans have 
                benefited from more than 6.5 million referrals to the 
                725,000 private healthcare providers with which the VA 
                is now working. On June 23, 2017, I signed the 
                Department of Veterans Affairs Accountability and 
                Whistleblower Protection Act of 2017 to hold our civil 
                servants accountable for maintaining the best quality 
                of care possible for our Nation's veterans by giving 
                the Secretary of Veterans Affairs more power to 
                discipline employees and shorten an appeals process 
                that can last years. On March 5, 2019, I signed 
                Executive Order 13861 (National Roadmap to Empower 
                Veterans and End Suicide) to ensure that the Federal 
                Government leads a collective effort to prevent suicide 
                among our veterans.

                I have used scientific research to focus on areas most 
                pressing for the health of Americans. On September 19, 
                2019, I signed Executive Order 13887 (Modernizing 
                Influenza Vaccines in the United States to Promote 
                National Security and Public Health), recognizing the 
                threat that pandemic influenza continues to represent 
                and putting forward a plan to prepare for future 
                influenza pandemics. To modernize influenza vaccines 
                and promote national security and public health, HHS 
                issued a 6-year, $226 million contract to retain and 
                increase capacity to produce recombinant influenza 
                vaccine domestically, and the National Institute of 
                Allergy and Infectious Diseases, part of the National 
                Institutes of Health within HHS, initiated the 
                Collaborative Influenza Vaccine Innovation Centers 
                program.

                Investments my Administration has made in scientific 
                research will help tackle some of our most pressing 
                medical challenges and pay dividends for generations to 
                come. This includes working to increase funding for 
                Alzheimer's disease research by billions of dollars 
                since 2017 and a plan to invest more than $500 million 
                over the next decade to improve pediatric cancer 
                research. On December 18, 2018, I signed the Sickle 
                Cell Disease and Other Heritable Blood Disorders 
                Research, Surveillance, Prevention, and Treatment Act 
                of 2018 to provide support for research into sickle 
                cell disease, which disproportionately impacts African 
                Americans and Hispanics, and to authorize programs 
                relating to sickle cell disease surveillance, 
                prevention, and treatment.

                On May 30, 2018, I signed the Trickett Wendler, Frank 
                Mongiello, Jordan McLinn, and Matthew Bellina Right to 
                Try Act of 2017, which gives terminally ill patients 
                the right to access certain treatments without being 
                blocked by onerous Federal regulations.

                In response to the COVID-19 pandemic, my Administration 
                launched Operation Warp Speed, a groundbreaking effort 
                of the Federal Government to engage with the private 
                sector to quickly develop and deliver safe and 
                effective vaccines, therapeutics, and diagnostics for 
                COVID-19. On August 6, 2020, I signed Executive Order 
                13944 (Combating Public Health Emergencies and 
                Strengthening National Security by Ensuring Essential 
                Medicines, Medical Countermeasures, and Critical Inputs 
                Are Made in the United States), to protect Americans 
                through reduced dependence on foreign manufacturers for 
                essential medicines and other items and to strengthen 
                the Nation's Public Health Industrial Base.

                Taken together, these extraordinary reforms constitute 
                an ongoing effort to improve American healthcare by 
                putting patients first and delivering continuous 
                innovation. And this effort will continue to succeed 
                because of my Administration's commitment to delivering 
                great healthcare with more choices, better care, and 
                lower costs for all Americans.

                Sec. 2. Policy. It has been and will continue to be the 
                policy of the United States to give Americans seeking 
                healthcare more choice, lower costs, and

[[Page 62185]]

                better care and to ensure that Americans with pre-
                existing conditions can obtain the insurance of their 
                choice at affordable rates.

                Sec. 3. Giving Americans More Choice in Healthcare. The 
                Secretary of the Treasury, the Secretary of Labor, and 
                the Secretary of Health and Human Services shall 
                maintain and build upon existing actions to expand 
                access to and options for affordable healthcare.

                Sec. 4. Lowering Healthcare Costs for Americans. (a) 
                The Secretary of Health and Human Services, in 
                coordination with the Commissioner of Food and Drugs, 
                shall maintain and build upon existing actions to 
                expand access to affordable medicines, including 
                accelerating the approvals of new generic and 
                biosimilar drugs and facilitating the safe importation 
                of affordable prescription drugs from abroad.

                    (b) The Secretary of the Treasury, the Secretary of 
                Labor, and the Secretary of Health and Human Services 
                shall maintain and build upon existing actions to 
                ensure consumers have access to meaningful price and 
                quality information prior to the delivery of care.

(i) Recognizing that both chambers of the Congress have made substantial 
progress towards a solution to end surprise billing, the Secretary of 
Health and Human Services shall work with the Congress to reach a 
legislative solution by December 31, 2020.

(ii) In the event a legislative solution is not reached by December 31, 
2020, the Secretary of Health and Human Services shall take administrative 
action to prevent a patient from receiving a bill for out-of-pocket 
expenses that the patient could not have reasonably foreseen.

(iii) Within 180 days of the date of this order, the Secretary of Health 
and Human Services shall update the Medicare.gov Hospital Compare website 
to inform beneficiaries of hospital billing quality, including:

  (A) whether the hospital is in compliance with the Hospital Price 
Transparency Final Rule, as amended (84 Fed. Reg. 65524), effective January 
1, 2021;

  (B) whether, upon discharge, the hospital provides patients with a 
receipt that includes a list of itemized services received during a 
hospital stay; and

  (C) how often the hospital pursues legal action against patients, 
including to garnish wages, to place a lien on a patient's home, or to 
withdraw money from a patient's income tax refund.

                    (c) The Secretary of Health and Human Services, in 
                coordination with the Administrator of CMS, shall 
                maintain and build upon existing actions to reduce 
                waste, fraud, and abuse in the healthcare system.

                Sec. 5. Providing Better Care to Americans. (a) The 
                Secretary of Health and Human Services and the 
                Secretary of Veterans Affairs shall maintain and build 
                upon existing actions to improve quality in the 
                delivery of care for veterans.

                    (b) The Secretary of Health and Human Services 
                shall continue to promote medical innovations to find 
                novel and improved treatments for COVID-19, Alzheimer's 
                disease, sickle cell disease, pediatric cancer, and 
                other conditions threatening the well-being of 
                Americans.

                Sec. 6. General Provisions. (a) Nothing in this order 
                shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or 
the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget 
relating to budgetary, administrative, or legislative proposals.

                    (b) This order shall be implemented consistent with 
                applicable law and subject to the availability of 
                appropriations.

[[Page 62186]]

                    (c) This order is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity by any party against 
                the United States, its departments, agencies, or 
                entities, its officers, employees, or agents, or any 
                other person.
                
                
                    (Presidential Sig.)

                THE WHITE HOUSE,

                    September 24, 2020.

[FR Doc. 2020-21914
Filed 9-30-20; 11:15 am]
Billing code 3295-F1-P