For more information on the AAMC’s response to the coronavirus (COVID-19) pandemic, visit the Coronavirus Resource Hub
The president signed the Families First Coronavirus Response Act (H.R. 6201, P.L. 116-127) on March 18. The House passed the bill in both a 363-40 vote on March 14 and a subsequent March 16 unanimous vote to add technical corrections. The Senate passed the measure in a 90-8 vote on March 18. The law marks the completion of the second supplemental legislative package considered by Congress as it seeks to contain and combat the COVID-19 pandemic.
The law includes provisions offering relief for Americans and providing additional resources to respond to the COVID-19 outbreak. Among those provisions are a 6.2% federal medical assistance percentage increase for states; requiring insurers — both public and private — to cover COVID-19 tests without cost-sharing or prior authorization requirements; $1 billion for the National Disaster Medical System; and funding for federal nutrition programs [see Washington Highlights, March 13].
The law also includes some key changes from the original bill, including requiring two weeks of paid sick leave resulting from COVID-19 for certain employees of public institutions or private employers with less than 500 employees. It also expands paid family and medical leave for child care due to school and day care closings for both private and public employers with less than 500 employees. Under the law, the secretary of labor has the right to exclude certain health care providers and emergency responders from the family and medical leave provisions. The program is set to sunset on Dec. 31, 2020. While tax credits are available to offset the cost of the paid leave for private employers with less than 500 employees, public institutions are not eligible for such credits.
Immediately following the passage and signing of the second supplemental legislation, Senate Majority Leader Mitch McConnell (R-Ky.) directed four working groups comprised of committee leadership to begin work on a third supplemental package. President Donald Trump has been vocal about his expectations for the package, with administration officials and congressional leaders alike publicly discussing a package that could top $1 trillion.
Sen. McConnell released text of a third supplemental package titled the Coronavirus Aid, Relief, and Economic Security (CARES) Act (S. 3548) on March 20. The proposed legislation contains measures designed to prevent further economic decline including small business loans, recovery checks for individuals and businesses, delayed tax measures, and loans to provide relief to airlines and other business sectors impacted by COVID-19.
Other key highlights related to health care and education include provisions that would:
- Address supply shortages by clarifying that additional supplies, such as swabs necessary for diagnostic testing, should be included in the Strategic National Stockpile.
- Clarify that private health plans are required to cover COVID-19 testing with no cost-sharing.
- Provide Medicare add-on payments of 15% for treating a patient with COVID-19 throughout the emergency period.
- Expand telehealth and eliminate the requirement that limits telehealth expansion authority to patients who had been seen by the provider or practice in the last three years.
- Provide supplemental funding for community health centers.
- Authorize telehealth grant programs through the Health Resource and Services Administration.
- Make the Food and Drug Administration priority review voucher incentive permanent.
- Allow the secretary of education to defer student loan payments, principal, and interest for three months without penalty to the student, with an additional three months’ deferment available if necessary.
- Ensure that students at eligible institutions whose semesters were ended due to the emergency do not have to return their Title IV aid or have the distributed aid count towards their loan limits.
- Allow institutions to issue work-study payments to a student who is unable to work due to work-place closures and granting institutions the ability to transfer unused work-study funds for supplemental grants.
Following its release, Democratic leadership stated that the package did not go far enough, and that “[t]o earn Democratic support in the Congress, any economic stimulus proposal must include new, strong and strict provisions that prioritize and protect workers.” The Senate is expected to rapidly work on the package with an expedited timeline for consideration and passage. The AAMC also submitted a letter to congressional leaders and Vice President Mike Pence on March 19 that urges their consideration of recommendations critical to ensuring that teaching hospitals, academic physicians, and medical schools are able to continue responding to the COVID-19 pandemic [see related story].
House Majority Leader Steny Hoyer (D-Md.) announced that the House will not return to Washington, D.C., until the third package is ready for a vote.