The COVID-19 pandemic forced us to search for new approaches to defining the principles of health systems, led to the diversification of health policies in both global and regional dimensions. This article considers regional health policies determined by the federal strategy of action in the period of COVID-19 pandemic in Russia and the socio-economic characteristics and political institutions of two regions - Moscow and the Republic of Tatarstan. Official documents reflecting statistical data, government response measures, speeches by regional leaders, and publications in the media were selected for analysis. The research uses materials from the Medialogy platform, which monitors the media and conducts the media analysis. In the period from October 2020 to June 2021, 5 focus groups were conducted with representatives of various categories of medical workers: primary care physicians (N = 27), specialist doctors (N = 12), doctors engaged in high-tech medicine (N = 12); a series of semi- standardized interviews with specialists (N = 15) with managerial experience in the healthcare system. The study shows that the two subjects of the federation, under the conditions of granted powers, chose different tactics of responding to the COVID-19 crisis, determined by well-established institutional mechanisms, models of habitual actions, and the choice of elites. In Moscow, from the very beginning of the pandemic, the policy has been identified with Mayor Sergei Sobyanin, who became the conductor of the toughest measures. In Tatarstan, the policy in the public sphere has been more determined by the republican headquarters and experts; President of the Republic Rustam Minnikhanov did not publicly take an active position. During the almost entire period of the development of the situation, Tatarstan provided low morbidity official data. Despite all the regional differences in policy and the choice of a compromise between morbidity, the stability of the health system, civic solidarity and the preservation of the economy, the results expressed in the statistics of excess mortality for 2020 and the first half of 2021 were equally alarming. Therefore, the development of the unified federal and variants of regional health policies that meet the current understanding of the pandemic and the needs of the population is an extremely urgent task.
