President Joe Biden signed the American Rescue Plan Act (P.L. 117-2), a $1.9 trillion COVID-19 relief package, into law on March 11. The House passed the final bill, 220-211, on March 10 after the Senate voted 50-49 to amend the House’s initial version on March 6 [see Washington Highlights, March 5].
The final package includes provisions that would impact academic medicine, its patients, and communities:
Access to Affordable Health Care Coverage
- Provides a 5 percentage point increase in the federal medical assistance percentage for two years for new states that decide to adopt Medicaid expansion under the Affordable Care Act (ACA).
- Provides 100% premium assistance through Sept. 30, 2021, for eligible individuals and families who lost their jobs and have elected to use COBRA to continue their employer-sponsored health coverage (an increase from 85% in the House-passed bill).
- Expands subsidies in the ACA marketplaces to those who earn above 400% of the poverty level and ensures that individuals with incomes below 150% of the poverty level or anyone who receives unemployment insurance in 2021 will pay no premiums. The enhanced subsidies would be available through 2022.
- Establishes a new state plan option to extend postpartum Medicaid and Children’s Health Insurance Program coverage for 12 months. The option would be available for seven years.
Public Health Measures and State and Local Funding
- Provides $350 billion for state, local, territorial, and tribal funding to address the fiscal impacts of COVID-19.
- Provides $47.8 billion to increase COVID-19 testing capacity and contact tracing, allowing for investments in resources such as academic research labs to expand testing capacity.
- Includes $7.5 billion for the Centers for Disease Control and Prevention (CDC) and $500 million for the Food and Drug Administration for COVID-19 vaccine activities, including promotion and distribution, as well as $1 billion to the CDC for public campaigns on vaccine confidence.
- Provides $6.05 billion to fund the supply chain for responding to COVID-19, including expenses related to research, personal protective equipment, vaccines, and more.
- Provides $1.75 billion for the CDC to increase genome sequencing of SARS-CoV-2 for variant surveillance.
- Includes $7.7 billion in awards under the Department of Health and Human Services to state, local, and territorial health departments to establish, expand, and sustain the public health workforce.
Workforce, Well-being, and Higher Education Funding
- Provides $800 million in supplemental funding for the National Health Service Corps and $330 million in supplemental funding for the Teaching Health Center Graduate Medical Education program.
- Includes $140 million in provider well-being grants [see related story].
- Provides $40 billion for the Higher Education Emergency Relief Fund.
Federally Funded Research
- Provides $600 million — available through Sept. 30, 2022 — for the National Science Foundation (NSF) to mitigate COVID-19 impacts to NSF researchers.
Following the bill signing, President Biden held a prime-time address to announce the administration’s next steps on combating the pandemic. Those steps include making every adult in the United States eligible for a COVID-19 vaccine no later than May 1, taking new steps to reopen schools, and continuing efforts to combat variants and the spread of COVID-19.