IFFGD is closely monitoring the coronavirus outbreak (also referred to as COVID-19 and SARS-CoV-2) and relevant legislation changes in response to this public health emergency. For those seeking up-to-date information on this outbreak and relevant public health concerns, please refer to the Centers for Disease Control (CDC) and World Health Organization (WHO). The following material highlights key provisions of this legislation with links to the full text and materials on congress.gov. Congress has been working to build this emergency response legislation in phases. The Coronavirus Preparedness and Response Supplemental Appropriations was phase 1, introduced on March 4, 2020 and signed in law on the 6th. Phase 2, the Families First Coronavirus Response Act, was signed into law on March 18th. Phase 3, The Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law on March 27, 2020.
The U.S. Food and Drug Administration (FDA) has created a webpage dedicated to addressing the relevant questions of patients and caregivers. Visit the Coronavirus Disease 2019 (COVID-19) Resources for Patients webpage to find information about FDA COVID-19 resources.
- Find information on hand sanitizers, treatment options, and more.
- Learn how to report a drug, biologic, or medical device product shortage
- Find information on clinical trials and the FDA’s Expanded Access program.
Vaccine Considerations for:
Specific summaries for:
Spanish Resources (Recursos en Español):
See Industry Expanded Patient Assistance and Industry Research and Trials on COVID-19 here
Executive Orders on COVID-19 Response
January 22, 2021
President Biden unveiled multiple Executive Orders and an economic relief proposal in response the the coronavirus pandemic. A white house briefing and fact sheet on these measures is available here.
Key measures include:
- Address the Growing Hunger Crisis Facing 29 Million Adults — And As Many As 12 Million Children.
- Increase access to nutritious food for millions of children missing meals due to school closures.
- Allow larger emergency Supplemental Nutrition Assistance Program allotments for the lowest-income households.
- Update food assistance benefits to reflect the true cost of a basic healthy diet.
- Ensure Equitable and Effective Delivery of Direct Stimulus Payments.
- Guarantee that No American Has to Choose Between Paying Their Bills and Keeping Themselves and Their Families Safe from COVID-19.
- Help Families, Workers and Small Businesses Access Relief Resources Quickly, Easily and Equitably through Coordinated Benefit Delivery Teams.
Omnibus Appropriations-Legislative Package-COVID Relief
Public Law No: 116-260; Previously H.R. 133
Status: Public Law
December 27th, 2020, a comprehensive omnibus legislation that includes the twelve annual Fiscal Year (FY) 2021 appropriations bills, additional emergency COVID-19 relief, and authorizing legislation was passed into law. The omnibus package passed with strong bipartisan support and provides $1.4 trillion in FY 2021 appropriations, with a sustained investment in medical research, public health, and education programs. The package also provides over $900 billion in economic stimulus and emergency supplemental funding to further support the COVID-19 public health response. Authorizing legislation incorporated into the package included a variety of healthcare bills.
Key items include:
FY 2021 Appropriations Bills
Labor-Health and Human Services-Education, and Related Agencies (L-HHS)
- $97 billion for the Department of Health and Human Services (HHS), an increase of $2.1 billion over FY 2020.
- $7.5 billion for the Health Resources and Services Administration (HRSA), an increase of $151 million over FY 2020.
- $7.9 billion for the Centers for Disease Control and Prevention (CDC), an increase of $125 million over FY 2020.
- $42.9 million for the National Institutes of Health (NIH), an increase of $1.25 billion over FY 2020.
- $6 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA), an increase of $133 million over FY 2020.
- $338 million for the Agency for Healthcare Research and Quality (AHRQ), level-funded from FY 2020.
- $4 billion for administration of the Centers for Medicare and Medicaid Services (CMS), level-funded from FY 2020.
- $551 million for the Office of the HHS Secretary, an increase of $6 million over FY 2020.
- $2.8 billion for the Public Health and Social Services Emergency Fund (PHSSEF), an increase of $110 million over FY 2020.
Health Resources and Services Administration (HRSA)
- $29.05 million for Organ Transplantation, an increase of $1.5 million over FY 2020
- $6 million for the National Living Donor Assistance Center, an increase of $1.5 million over FY 2020
Centers for Disease Control and Prevention (CDC)
- $1.31 billion for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, an increase of $40.5 million over FY 2020
- $39.5 million for Viral Hepatitis, a $500 thousand increase over FY 2020
- $1.28 billion for Chronic Disease Prevention and Health Promotion at CDC, an increase of $36.75 million over FY 2020
- $1.5 million for a new Chronic Disease Education and Awareness Program, an increase of $1.5 million over FY 2020
- $1 million for Inflammatory Bowel Disease, level funded with FY 2020
- $385.80 million for Cancer Prevention and Control, an increase of $4.80 million over FY 2020
- $43.29 million for Colorectal Cancer, level funded with FY 2020
National Institutes of Health (NIH)
- $6.56 billion for the National Cancer Institute, an increase of $119.41 million over FY 2020
- $195 million from the NIH Innovation Account to NCI to support the Cancer Moonshot Initiative
- $2.13 billion for the National Institute of Diabetes and Digestive and Kidney Diseases, an increase of $17.66 million over FY 2020
- $6.07 billion for the National Institute of Allergy and Infectious Diseases, an increase of $184.15 million over FY 2020
- $855.42 million for the National Center for Advancing Translational Sciences, an increase of $22.53 million over FY 2020
- $2.41 billion for the Office of the Director, an increase of $171.32 million
- $635.94 million for the Common Fund, an increase of $9.43 million
Department of Defense (DoD)
- $33.68 billion for the Defense Health Program, an increase of $45 million over FY 2020
- $115 million for the Peer-Reviewed Cancer Program, an increase of $5 million over FY 2020
- $370 million for the Peer-Reviewed Medical Research Program, an increase of $10 million over FY 2020
- $22 million for Peer-Reviewed Gulf War Illness Research, level funded with FY 2020
- $6 million for Peer-Reviewed Pancreatic Cancer Research, level funded with FY 2020
- $7.5 million for Peer-Reviewed Rare Cancers Research, level funded with FY 2020
- $10 million for Combat Readiness Medical Research, level funded with FY 2020
- $3 billion to reimburse hospitals and healthcare providers for lost revenue.
- Provides a 3.75% (one-time) increase in the Medicare physician fee Schedule for 2021.
- Continues the Paycheck Protection Program (PPP) and other small business support.
Agriculture, Rural Development, Food and Drug Administration, and Related Agencies (Ag-FDA)
- $3.2 billion is discretionary funding for the Food and Drug Administration (FDA), an increase of $43 million over FY 2020. The total funding for FDA is $5.97 billion when user fees are included.
Military Construction, Veterans Affairs, and Related Agencies (MilCon-VA)
- $815 million for the VA Medical and Prosthetic Research Program, an increase of $15 million over FY 2020.
Supplemental COVID-19 Response
- $73 billion in additional funding for HHS.
- $8.75 billion in additional funding for CDC.
- $1.25 billion in additional funding for NIH.
- $4.25 billion in additional funding for SAMHSA.
- $22.95 billion in additional funding for the Assistant Secretary for Preparedness and Response in the Office of the HHS Secretary.
- $25.4 billion in additional funding for the Public Health and Social Services Emergency Fund.
- Provides a 3.75% (one-time) increase in the Medicare physician fee Schedule for 2021.
- Extends the Paycheck Protection Program (PPP) and other small business/non-profit support.
- Enacts the No Surprises Act to address the practice of “surprise” medical billing.
- Extends the Rare Pediatric Disease Priority Review Voucher Program at FDA.
- Waives Medicare coinsurance for certain colorectal cancer screening tests, by gradually eliminating cost-sharing for Medicare beneficiaries with respect to colorectal cancer screening tests where a polyp is detected and removed.
- Allows hospitals to host a limited number of residents for short-term rotations without being negatively impacted by a set permanent full-time equivalent (FTE) resident cap or a Per Resident Amount (PRA).
- Authorizes CMS, when determining payment for products covered under Medicare Part B, to review and exclude payments made for the self-administered versions of products that are not covered under Part B.
Relevant Conference Report Language:
Health Resources and Services Administration
- Organ Allocation Policy – HRSA and the Organ Procurement and Transplantation Network are encouraged to ensure the process for changing organ allocation policies is transparent, thorough, and accommodates the recommendations of transplantation and organ donation professionals.
Centers for Disease Control and Prevention
- Infectious Diseases and the Opioid Epidemic – The agreement provides an increase to strengthen surveillance to improve knowledge of the full scope of the burden of infectious diseases (including viral, bacterial, and fungal pathogens) associated with substance use disorders. CDC is encouraged to consider risk factors for hepatitis B and C, JilV, and morbidity and mortality related to substance use disorder among other factors when distributing funding.
- Opioid Prescribing Guidelines – The agreement directs CDC to continue its work educating patients and providers on its Guidelines for Prescribing Opioids for Chronic Pain, and to encourage uptake and use of the guidelines.
- Incontinence Among Older Americans – The agreement directs CDC to provide an update to the June 2014 report on the prevalence of incontinence among older Americans, including prevalence among both institutionalized and non-institutionalized populations in the fiscal year 2023 Congressional Justification.
Agency for Health Research and Quality
- Organ Availability – The agreement urges AHRQ to evaluate innovative approaches to enhance the availability of organs, otherwise encourage donation, and further improve the organ transplantation process, including through consultation with other Federal agencies.
Centers for Medicare and Medicaid Services
- Computed Tomography (CT) Colonography – The agreement encourages CMS to consider existing evidence to determine whether CMS should cover CT colonography as a Medicare-covered colorectal cancer screening test under section 186I(pp)(l) of the Social Security Act.
Department of Defense
- Peer-Reviewed Medical Research Program: The agreement provides $370,000,000 for a peer-reviewed medical research program. The Secretary of Defense, in conjunction with the Service Surgeons General, is directed to select medical research projects of clear scientific merit and direct relevance to military health. Research areas considered under this funding are restricted to: arthritis, burn pit exposure, cardiomyopathy, congenital heart disease, diabetes, dystonia, eating disorders, emerging viral diseases, endometriosis, epidermolysis bullosa, familial hypercholesterolemia, fibrous dysplasia, focal segmental glomerulosclerosis, food allergies, Fragile X, frontotemporal degeneration, hemorrhage control, hepatitis B, hydrocephalus, hypertension, inflammatory bowel diseases, malaria, metals toxicology, mitochondrial disease, myalgic encephalomyelitis/chronic fatigue syndrome, myotonic dystrophy, non-opioid therapy for pain management, nutrition optimization, pathogeninactivated blood products, peripheral neuropathy, plant-based vaccines, platelet like cell production, polycystic kidney disease, pressure ulcers, pulmonary fibrosis, respiratory health, rheumatoid arthritis, sleep disorders and restriction, suicide prevention, sustained release drug delivery, vascular malformations, and women’s heart disease. The additional funding provided under the peer-reviewed medical research program shall be devoted only to the purposes listed above.
- Peer-Reviewed Cancer Research Program: The funds provided in the peer-reviewed cancer research program are directed to be used to conduct research in the following areas: cancers associated with the use of beryllium; bladder cancer; blood cancers; brain cancer; colorectal cancer; endometrial cancer; esophageal cancer; germ cell cancers; head and neck cancer; liver cancer; lymphoma; mesothelioma; metastatic cancers; neuroblastoma; pediatric brain tumors; pediatric, adolescent, and young adult cancers; sarcoma; stomach cancer; thyroid cancer, and the link between scleroderma and cancer. The peer-reviewed cancer research program shall be used only for the purposes listed above. The inclusion of the individual rare cancer research program shall not prohibit the peer-reviewed cancer research program from funding the above-mentioned cancers or cancer subtypes that may be rare by definition.
- Gulf War illnesses – The agreement directs the Department to submit a report to the Committees on Appropriations no later than 180 days after enactment of this Act on the progress of research related to the incidence and prevalence of brain cancer in Gulf War veterans, and any research related to respiratory illnesses experienced by veterans who served in the Persian Gulf, Iraq and Afghanistan.
Senate – Delivering Immediate Relief to America’s Families, Schools and Small Businesses Act
Status: Proposed Ammendment to Legislation
August 18th, Senate leadership released this proposed legislation that contains $500 billion in proposed COVID-19 releif spending. This legislation is considered a scaled back version of the HEALS Act proposal.
Senate – HEALS Act
Status: Senate Proposed Legislation
On July 31st, the Senate Republicans proposed the HEALS Act. The proposal is comprehensive, totals nearly $1 trillion, and represents the sixth COVID-19 response package considered by Congress. The $1 trillion dollar Senate package draws sharp policy contrasts with the $3 trillion House bill, but does include emergency supplemental appropriations, further economic stimulus measures, and coverage and access provisions.
Notably absent from the proposal are:
- A National COVID Testing Strategy mandate. The bill does include spending for COVID testing/diagnostics, vaccine, and treatment provision, but does not match the House bill’s national testing strategy mandate.
- Additional meaningful relief for mid-to-large non-profit organizations or significant state or local government relief.
Senate Republicans are divided in their support/opposition to the HEALS Act, so it appears that the Senate may need to rely on a bipartisan coalition of Republicans and Democrats in order to secure enough votes to consider the package on the Senate Floor, and ultimately negotiate a compromise bill with the House.
Key provisions include:
Coronavirus Response Additional Supplemental Appropriations Act:
Departments of Labor, Health and Human Services, Education, and Related Agencies (L-HHS)
- $3.4 billion for the Centers for Disease Control and Prevention (CDC).
- $1.5 billion for state, local, and territorial health needs.
- $500 million for seasonal flu vaccination efforts.
- $200 million for global health.
- $15.5 billion for the National Institutes of Health (NIH).
- $290 million for the National Heart, Lung, and Blood Institute (NHLBI).
- $200 million for the National Institute on Diabetes and Digestive and Kidney Diseases (NIDDK).
- $481 million for the National Institute of Allergy and Infectious Diseases (NIAID).
- $64 million for the National Institute on Minority Health and Health Disparities (NIMHD).
- $13 billion for the Office of the NIH Director.
- $10 billion to support NIH-funded research labs (re-open and replace losses).
- $1.24 billion for the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) initiative.
- $240 million for young investigators (training and career development).
- $1.33 billion for COVID-19 research efforts at “smaller” NIH Institutes and Centers.
- Extends the obligation period for FY 2015 NIH grants through FY 2021.
- $78.1 billion for the Public Health and Social Services Emergency Fund.
- $25 billion for Provider Relief.
- $16 billion for testing, contact tracing, and surveillance.
- $20 billion for the Biomedical Advanced Research and Development Authority (BARDA).
- $2 billion for the Strategic National Stockpile.
- $7.6 billion for Community Health Centers.
- $250 million for Children’s Hospital Graduate Medical Education.
- $105.1 billion for the Department of Education.
Department of Defense (DoD)
- $2.61 billion for DoD to facilitate social distancing, and to purchase personal protective equipment (PPE) and related supplies.
- $5.3 billion to further address COVID-19 through the Defense Production Act.
- $705 million for the Defense Health Agency to further respond to COVID-19.
American Workers, Families, and Employers Assistance Act:
- Reduces the $600 per week enhanced unemployment benefit to $200 per week.
- Provides supplemental unemployment relief for state governments and non-profits by allowing states to reimburse nonprofits, government agencies, and Indian tribes for 75% the costs they incur through December 31, 2020 to pay unemployment benefits.
- Provides $90 billion additionally for the Paycheck Protection Program.
- $25 billion is set aside for organizations with 10 or fewer employees, $10 billion is set aside for community lenders, and the administrator is directed to prioritize underserved communities.
- Paycheck Protection Program (PPP) Second Draw Loans are available to organizations that have already received a PPP loan.
- Must employ 300 or fewer employees.
- Demonstrate at least a 50% reduction in gross receipts during the first or second quarter of 2020 compared to the same 2019 quarter.
- Maximum PPP Second Draw Loan is $2 million
- Enhances the employee retention tax credit (ERTC) to 65% of wages paid by employers to employees during the COVID-19 pandemic.
- Provides authority to extend Medicare telehealth waivers, and extends telehealth flexibility for community health centers and rural clinics.
- Promotes COVID-19 testing and infection control in nursing facilities (by enhancing diagnostic testing for visitors, staff, and residents).
- Up to $5 billion would be provided by HHS for broad efforts to address COVID-19 in nursing homes.
Safely Back to School and Back to Work Act:
- Requires HHS (through CDC and FDA) to establish and publish policies and procedures for public and private entities to access samples of specimens containing infectious disease agents, or suitable surrogates or alternatives to support the development of products, including the development of diagnostic tests, treatments, or vaccines, to address emerging infectious diseases for biomedical research.
- Encourages CDC to enter into agreements with public and private stakeholders to rapidly develop and disseminate diagnostic tests.
- Requires HHS (through CDC and FDA) to consult with medical product manufacturers, suppliers, and other relevant stakeholders to identify specific supply needs, including specimen collection and transport materials, reagents, or other supplies; identify projected demand and availability of such supplies; and support activities to increase the availability of such supplies or appropriate alternatives.
- Supports domestic manufacturing efforts to produce COVID-19 countermeasures.
- Encourages the utilization of state stockpiling, and stockpile coordination through the federal government (calls for state stockpiling plans), and authorizes funding to support stockpiling.
- Extends existing CARES Act waivers for foreign institutions through the end of the 2020-2021 award year or the end of the qualifying emergency.
Additional HEALS Act Coronavirus Response Spending Provisions:
Department of Homeland Security (DHS)
- $150 million for the Federal Emergency Management Agency (FEMA).
- $930 million for FEMA grants.
Department of State, Foreign Operations, and Related Programs (S-FOPS)
- $4 billion for the US Agency for International Development (USAID).
- $3 billion for Global Health.
Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act
Status: Passed by the House of Representatives on 5/15/2020
On May 12th, the Democratic leadership of the House of Representatives released the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act. The proposal is comprehensive, totals nearly $3 trillion, and represents the fifth COVID-19 response package considered by Congress. The House is passed this response package on May 15th.
Key provisions include:
Emergency Supplemental Appropriations
Department of Health and Human Services
- $4.75 billion for the National Institutes of Health (NIH) to assist with relevant research and to support biomedical research laboratories across the country.
- $4.58 billion for the HHS Assistant Secretary for Preparedness and Response, including-
- $3.5 billion for the Biomedical Research and Development Authority (BARDA) for therapeutic and vaccine development.
- $500 million for BARDA to support U.S. “next generation” manufacturing facilities.
- $500 million for BARDA to advance antibacterial research and development.
- $175 billion for the Public Health and Social Services Emergency Fund to reimburse for healthcare related expenses or lost revenue, and to support testing and contact tracing, including-
- $100 billion for reimbursement grants to hospitals and healthcare providers.
- $75 billion for testing, contact tracing, and related response activities.
- $3 billion for the Substance Abuse and Mental Health Services Administration, including-
- $1.5 billion for Substance Abuse Prevention and Treatment Block Grants.
- $7.61 billion for the Health Resources and Services Administration (HRSA), including-
- $7.6 billion for Community Health Centers for testing and healthcare.
- $10 million for Ryan White HIV/AIDS clinics to accommodate high risk patients.
- $2.1 billion for the Indian Health Service to support healthcare activities, including-
- $1 billion to address lost revenue from reduced medical care.
- $64 million to assist Urban Indian Organizations.
- $10 million for sanitation, hydration, and hygiene.
- $500 million for healthcare and telehealth.
- $140 million for broadband and health IT.
- $20 million to support victims of domestic violence.
- At least $366 million to facilitate quarantine and social distancing
- $25 million for the Centers for Medicare and Medicaid Services to support Healthcare Fraud and Abuse Control activities.
- $1.3 billion to assist the Federal Emergency Management Agency with response activities.
- $900 million to assist tribal governments with response activities.
- $125 million for the National Science Foundation to assist with response activities.
Department of Education
- $90 billion for a State Fiscal Stabilization Fund at the U.S. Department of Education to support funding for public schools, including general expenditures for institutions related to service disruption.
- $10.5 billion to alleviate COVID-19 related burdens for both schools and students, including-
- $1.7 billion for Historically Black Colleges and Universities.
- $20 million for Howard University.
- $8.4 billion for other institutions of higher education.
- Replaces the mandatory $62 million cap on funding for Historically Black Colleges and Universities (HBCUs) Capital Financing Program with “such sums”.
- Extends the definition of “distance education” as proposed by the Department on April 2nd, 2020, to programs that begin after August 15th and effectively extends the provision to the end of the 2020-2021 award year.
Department of Justice
- $200 million for the Bureau of Prisons to conduct response activities, including testing and medical services.
Coverage and Access
- Provides a 10% increase in federal payments to Medicaid programs for home and community-based services.
- Provides a 14% increase in Federal Medical Assistance Payments to Medicaid programs.
- Eliminates Medicaid cost-sharing for COVID-19 vaccines or treatments.
- Provides a State option to cover for COVID-19 treatment for the uninsured through Medicaid.
- Provides a 2.5% increase in Medicaid payments to Disproportionate Share Hospitals.
- Provides no-cost sharing for individuals that receive care for COVID-19 through Medicare Part A or B.
- Ensures that COVID-19 treatments are provided at no-cost through the Medicare Advantage Program.
- Requires broad Medicare coverage of COVID-19 treatments without cost-sharing or utilization management protocols.
- Creates a new special enrollment period for Medicare Part A and B, as well as through the federal exchanges for private coverage.
- Ensures items and services needed to treat COVID-19 are provided with no cost-sharing through private insurance.
- Makes the requirement for free COVID-19 testing retroactive to the start of the public health emergency.
- Extends requirements for no-cost sharing to treat COVID-19 to TRICARE and the VA health system (including no-cost for preventative services within the VA).
- Requires the appointment of a qualified Medical Supplies Response Coordinator to oversee supply chain logistics.
- Asks the National Academies to conduct a review and make recommendations to encourage domestic manufacturing of critical drugs.
- Asks the Government Accountability Office (GAO) to study the feasibility of a Strategic National Stockpile user-fee arrangement.
- Asks the GAO to study and report on the diagnostic testing response.
- Requires HHS to issue a new and detailed (updated) plan for testing.
- Requires every laboratory conducting COVID-19 tests to report daily results to HHS.
- Authorizes $6 billion to modernize public health departments.
- Authorizes $1 billion for the Centers for Disease Control and Prevention to modernize its public health infrastructure.
- Requires CDC to establish a national system for testing and contact tracing, this includes issuing grants to State, local, and Tribal governments.
- Deploys the Defense Production Act to increase production and supply of critical items, including diagnostic tests.
- Updates the ongoing blood donation public awareness campaign to also include the importance of the plasma supply.
- Establishes a public health workforce loan repayment program.
- Authorizes grants to medical schools in rural or underserved areas, or minority-serving institutions to expand ongoing activities or establish new schools.
- Releases certain territories and localities from “Buy American” requirements, allowing them to source medical equipment from nearly any supplier.
Economic Stimulus Measures
- Requires lenders participating in the Main Street Lending Program to provide at least one low cost loan option to small businesses and non-profits that does not have a minimum loan size limit.
- Extends financial relief available for qualifying non-profits organizations to January 31st, 2021.
- Provides a (up to) 50% refundable tax credit for fixed costs for employers impacted by COVID-19.
- Temporary moratorium on small business and nonprofit debt collection during the COVID19 crisis, and for 120 days thereafter.
- Provides (up to) $10,000 in debt relief for private student loan borrowers.
- Extends loan relief for all federal student loan borrowers.
- Extends unemployment benefits related to COVID-19.
- Extends certain family and medical leave benefits related to COVID-19.
- Makes certain adjustments to personal tax credits for 2020 filings.
- Provides a (up to) 90% business interruption tax credit for self-employed individuals impacted by COVID-19.
State and Local Assistance
- $500 billion to assist State governments with fiscal impacts.
- $375 billion to assist local governments with fiscal impacts.
- $20 billion to assist Tribal governments with fiscal impacts.
- $20 billion for assist territorial governments with fiscal impacts.
- $755 million to assist the District of Columbia with response efforts and fiscal impacts.
The Paycheck Protection Program and Health Care Enhancement Act
Public Law No. 116-139, previously known as H.R. 266
Status: Public Law on 4/24/2020
On April 21st, the Senate unanimously passed this additional coronavirus (COVID-19) response legislation, the House of Representatives passed the measure on April 23rd. The president signed the bill into law on April 24th. While totaling nearly $500 billion, this is a narrow response package targeted at further emergency supplemental appropriations and economic stimulus. Many members of Congress remain interested in a subsequent, comprehensive COVID-19 response package, but the political path forward for such a proposal is unclear at this time.
Key provision include:
Emergency Healthcare Appropriations
- $25 billion in additional funding to research, develop, and administer testing.
- $1.8 billion in additional funding for the National Institutes of Health (NIH) to advance research and assist in the development of tests, vaccines, and related countermeasures.
- $22 million in additional funding for the Food and Drug Administration (FDA) to ensure meritorious new products can quickly reach those in need.
- $1 billion in additional funding for the Biomedical Advanced Research and Development Authority (BARDA) to support research and response activities.
- $1 billion in additional funding for the Centers for Disease Control and Prevention (CDC) to conduct surveillance, contact tracing, and additional public health activities.
- $825 million in additional funding for Community Health Centers to support ongoing response activities.
- $1 billion in additional funding to further provide testing for the uninsured.
- $75 billion in additional funding to reimburse hospitals and healthcare providers to support ongoing response efforts and replace lost revenue.
Economic Stimulus Measures
- Provides $310 billion to replenish the Paycheck Protection Program.
- Sets aside $30 billion in loans for community banks and small lenders with less than $10 billion in assets.
- Sets aside $30 billion in loans for medium-sized financial institutions and lenders with $10 to $50 billion in assets.
- This program is designed to provide a direct incentive for small businesses to keep their workers on the payroll and the loan will be forgiven if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest, or utilities.
- Applications can be made through any existing SBA 7(a) lender or through any federally insured depository institution, federally insured credit union, and Farm Credit System institution that is participating.
- More information and the application can be found here: Paycheck Protection Program
- $10 billion in additional funding for Emergency Economic Injury Disaster grants.
- Economic Injury Disaster Loans are awarded up to $10,000 for entities that are experiencing a temporary loss of revenue. Funds will be made available following a successful application and will not have to be repaid.
- Eligible recipients are small business with less than 500 employees (including sole proprietorships, independent contractors and self-employed persons), private non-profit organization.
- More information and the application can be found here: Emergency Economic Injury Disaster Program
- $50 billion in additional funding for the Disaster Loans Program Account.
- The Small Business Administration also has other options for relief and they can be found here: SBA Coronavirus Relief Options
The Coronavirus Aid, Relief, and Economic Security (CARES) Act
Public Law No. 116-136, previously known as H.R. 748
Status: Public Law on 3/27/2020
Following swift negotiations, Congress and the administration reached agreement on a “phase 3” legislative package responding to coronavirus (COVID-19). The final package totals nearly $2 billion and represents a compromise between the competing bills recently put forward by Senate Republicans and House Democrats. The phase 3 response package remains a combination of emergency supplemental appropriations, health policy provisions, and economic stimulus measures.
On March 25, 2020, the Senate unanimously passed H.R. 748 (bill text here), the House quickly followed by passing the bill on March 27, 2020, and President Trump signed this legislation into law on March 27, 2020.
Key provisions of this legislation include:
- $172 billion for Labor, Health and Human Services (HHS), and Education (Ed).
- $127 billion for the Public Health and Social Services Emergency Fund.
- $100 billion to address lost revenue and expenses for hospitals and healthcare providers responding to COVID-19.
- $16 billion for the Strategic National Stockpile for personal protective equipment (PPE), ventilators, and other related medical supplies.
- $3.5 billion for vaccines, therapeutics, diagnostics, and other medical preparedness.
- $275 million for the Health Resources and Services Administration (HRSA) to support related activities through rural health, community health centers, and the Ryan White program.
- $4.3 billion for the Centers for Disease Control and Prevention (CDC).
- $1.5 billion for State and Local Preparedness ($2.5 billion in total additional funding when combined with previous supplemental funding).
- $500 million for Global Health ($800 million in total additional funding when combined with previous supplemental funding).
- $300 million for the Infectious Disease Funds ($600 million in total additional funding when combined with previous supplemental funding).
- $945.5 million for the National Institutes of Health (NIH), this brings total additional funding for NIH up to $1.78 billion when combined with previous supplemental funding.
- $425 million for the Substance Abuse and Mental Health Services Administration to conduct core activities that respond to COVID-19.
- $30.9 billion for Education
- $14.25 billion for institutes of higher education to support both institutions and students impacted by COVID-19 with specific funding for historically black colleges and universities (HBCUs).
- $13 million in direct support for Howard University.
- $127 billion for the Public Health and Social Services Emergency Fund.
- $35 billion for Agriculture, Rural Development, Food and Drug Administration (FDA) and Related Agencies.
- $25 million for a new grant program to support distancing learning and telemedicine (through rural development activities).
- $80 million for FDA to support development of therapies, diagnostic tools, vaccines, and medical countermeasures.
- $10.5 billion for the Department of Defense (DoD).
- $1 billion for the Defense Production Act to support production of PPE and other critical items.
- $1.8 billion for the Defense Health Program to support addressing additional medical costs as well as the acquisition of countermeasures and related equipment.
- $1.6 billion for the Defense Health Program to expand care capacity and bolster treatment facilities.
- $415 million for the development of vaccines, lab operations, and the procurement of diagnostic tests.
- $628 million for non-medical protective equipment and other supplies.
- $2 billion for Interior, Environment, and Related agencies.
- $7 million to assist the Environmental Protection Agency with responding to COVID-19.
- $20 billion for Military Construction, Veterans Affairs (VA), and Related Agencies.
- $14.4 billion to support the delivery of VA medical services.
- $606 million for the VA to advance alternative sites of care and mobile treatment centers.
- Seeks to mitigate shortages of emergency products by prioritizing review of drug applications and providing additional incentives.
- Places further reporting requirements on manufacturers related to drug shortages or production challenges (mainly related to products needed for emergency response of COVID-19).
- Provides specific guidance for the coverage, reimbursement, and pricing related to COVID-19 diagnostic tests.
- Supports an awareness campaign and related activities related to the safety of the blood supply and importance of blood donation.
- Provides rapid coverage by third party-payers for preventative services and vaccines.
- Reauthorizes the Health Professions Workforce Programs (Title VII).
- Enhanced reporting requirements for the discontinuation of medical devices needed for the emergency response.
- Provides access to telehealth services for individuals with high deductible plans and health savings accounts (without incurring out of pocket costs).
- Further expands access to telehealth services to ensure patients have access to a broad range of providers.
- Provides flexibility to allow community health centers and rural health clinics to provide telehealth services.
- Provides flexibility for patients to access home health services.
- Removes Medicare sequester through the end of the calendar year, but then extends the sequestration for an additional year.
- Blocks scheduled reductions in Medicare payments for durable medical equipment.
- Eliminates Medicare Part B cost-sharing requirements for COVID-19 vaccines.
- Allows for a 90-day supply of covered medications under Medicare Part D.
- Ensures Medicaid patients can receive a COVID-19 test and related services with no cost-sharing requirements.
- Ensures Medicare beneficiaries can receive a test for COVID-19 under Medicare Part B with no cost-sharing requirements.
- Prevents 2021 scheduled reductions in Medicare diagnostic tests for clinical laboratories.
- Provides an extension of the Medicare accelerated payment programs for hospitals.
- Extends funding for the National Quality Forum to carry out ongoing quality management and performance improvement measures.
- Delays scheduled reductions to Medicaid payments for disproportionate share hospitals.
- Extends the Health Careers Opportunity Grant program.
- Extends authorization for and enhances funding for;
- Community Health Centers,
- the National Health Service Corps, and
- Teaching Health Centers that operate GME programs.
- Provides campus-based aid waivers.
- Deploys supplemental education opportunity grants for emergency aid to assist students with unexpected expenses.
- Facilitates continuing education through distance learning at affected foreign institutions.
- Provides national emergency educational waivers.
- $62 million to provide capital financing to HBCUs.
- Provides interest and payment relief for student loan borrowers.
- Creates a COVID-19 unemployment assistance program through the end of the calendar year and provides an overall increase to unemployment benefits.
- Provides emergency unemployment relief to non-profits and government entities.
- Provides a recovery rebate for individuals and families.
- Provides flexibility to withdraw funds from retirement accounts.
- Enhances deductions to charitable organizations (whether deductions are itemized or not). Further incentivises individuals and organizations to make charitable donations.
- Provides an employee retention credit to business forced to shut down or reduce operations as a result of COVID-19.
- Provides a variety of additional adjustments to the tax code.
- Numerous modifications are made to the Family and Medical Leave Act, the Emergency Paid Family Leave Act, and the unemployment insurance program.
Families First Coronavirus Response Act
Public Law No: 116-127, previously known as H.R. 6201
Status: Public Law on 3/18/2020
On March 14th, the House of Representatives passed the Families First Coronavirus Response Act (H.R. 6201) with overwhelming bipartisan support. On March 18th, the Senate passed the House bill and the president quickly signed the measure into law. No substantive changes were made to H.R. 6201.
- $1 billion to help cover the cost of coronavirus testing for the uninsured.
- $82 million in resources for the Department of Defense to test military personnel and their families for coronavirus through the Defense Health Program.
- $64 million in resources for the Indian Health Service to conduct coronavirus testing.
- $60 million for the Veterans Administration to conduct coronavirus testing.
- Cost-sharing requirements under Medicare for coronavirus testing are waived.
- Cost-sharing requirements through Medicare Advantage are also waived and private insurance is required to provide access to coronavirus testing at no cost.
- Medicaid and CHIP are directed to provide coronavirus testing at no cost.
- Bolstered support for food banks and federal nutrition assistance programs, including assistance for children that normally receive meals through a school that has been closed.
- Bolstered support for nutrition and meal delivery services that serve senior citizens.
- Enhanced and targeted tax credits for relevant medical leave.
- Numerous statutory changes related to how impacted individuals engage unemployment, medical leave, nutrition assistance, and related federal programs.
Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020
Public Law No: 116-123, previously known as H.R. 6074
Status: Public Law on 3/06/2020
The Coronavirus Preparedness and Response Supplemental Appropriations Act (H.R. 6074) was introduced on March 4, 2020, passing the House the same day, and passing the Senate on March 5, 2020. On March 6th, President Trump signed this bill into law, allotting $8.3 billion in emergency spending for state and local governments, assistance for small businesses affected by the coronavirus, and funding for a robust international response.
This funding measure includes:
- $2.2 billion for the Centers for Disease Control and Prevention (CDC), supporting surveillance and testing, as well as both domestic and global health initiatives.
- $2 billion for the Biomedical Advanced Research and Development Agency (BARDA), supporting the development of vaccines, therapeutics, and diagnostic.
- $826 million for the National Institutes of Health (primarily NIAID), supporting research that advances efforts to develop vaccines, therapeutics, and diagnostics.
- $1 billion for Healthcare Preparedness, Pharmaceuticals and Medical Supplies, and Community Health Centers to support medical surge capacity.
- $435 million for the Global Health Response to support overseas efforts to prevent and respond to coronavirus.
Expressing the sense of the House of Representatives that there should be a direct emergency economic stimulus for individual Americans in response to COVID-19
This resolution was introduced in the House of Representatives on March 12, 2020, and referred to the Committee of Ways and Means that same day. H. Res. 897 communicates that the House strongly feels the federal government should create and provide an emergency payment of $1,000 per month for all Americans until HHS (the Department of Health and Human Services) declares that the COVID-19 outbreak is no longer considered a public health emergency. The considerations of this legislation were included in H.R. 748.
COVID-19 Health Care Worker Protection Act of 2020
This legislation was introduced in the House of Representatives on March 9, 2020. On the same day, this bill was referred to the Committees on Education and Labor, Ways and Means, and Energy and Commerce. Each committee was responsible for the consideration of provisions that fall within each jurisdiction. The considerations of this legislation were included in H.R. 748.