Congress cleared a $1.9 trillion COVID-19 relief bill on March 10 – one of the largest rescue packages in American history – that will provide funding towards vaccine distribution, contact tracing, increasing the child tax credit, boosting unemployment payments, $1,400 stimulus checks to eligible households, and aid for small businesses, states, territories and tribal governments. The legislation, entitled the American Rescue Plan, marks the sixth aid package Congress has passed since last March. President Biden signed the bill on Thursday afternoon.

The Senate passed the bill in a 50-49 vote after making changes to the original version passed by the House. An amendment was offered during the Senate vote-a-rama to provide for an extension of the temporary suspension of Medicare sequestration, but it was ultimately not accepted. Congress included provisions in the Consolidated Appropriations Act, 2021, signed into law last December, that further postponed the 2% Medicare sequester until March 31. The ACC joined forces with over 100 other medical specialty societies to urge the importance of Congress taking immediate steps to further postpone the imposition of the Medicare sequester. However, absent additional Congressional intervention, these payment cuts will be re-imposed on April 1.

In addition, the statutory Pay-As-You-Go Act of 2010 (PAYGO) states that spending increases and tax cuts that add to the deficit will automatically trigger cuts the following calendar year. Without further action, passage of this relief package could result in 4% cuts to Medicare and cuts to other federal programs for 2022. ACC Advocacy and others in the House of Medicine continue to engage Congress to halt the pending cuts and will communicate updates to members as they become available.

Highlights from the COVID-19 relief bill include:

Rural Health Care: This bill will increase vaccine distribution capacity, provide medical supplies and medical surge capacity, expand access to telehealth and help to fill the gap for rural healthcare providers.

Vaccines: In order to ensure vaccines reach every community as quickly as possible, there is $7.5 billion in the Centers for Disease Control and Prevention funding for vaccine distribution.

Testing: The bill provides $48.3 billion for testing in order to contain the virus and mitigate its effects, hire staff for contact tracing, provide personal protective equipment for frontline health workers and take other steps to combat the virus.

Health Workforce: The bill provides $7.66 billion to bolster the public health workforce and COVID-19 pandemic response.

Community Health Centers and Health Disparities: This includes $7.6 billion for community health centers, $1.44 billion for Older Americans Act programs, $800 million for the National Health Services Corps and more.

State and Local Fiscal Aid: The bill includes direct aid to state and local governments, providing $350 billion to states, territories, tribes and local governments to be used for responding to the COVID-19 public health emergency, to offset revenue losses, bolster economic recovery and to provide premium pay for essential workers.

Health Coverage: The bill includes five main provisions pertaining to health coverage. First, over the next two years, it invests nearly $35 billion in premium subsidy increases for those who buy coverage on the Affordable Care Act (ACA) marketplaces. Second, the bill forgives more than $6 billion in payments that people would need to make if their 2020 advanced premium subsidies did not match their income. Third, the bill provides an incentive for states to expand Medicaid, offering them a 5% increase on their base Federal Medical Assistance Percentage rate for two years if they expand coverage. Fourth, the bill subsidizes 100 percent of COBRA premiums for six months for individuals who lost employment or had reduced hours. Fifth, for one year, the bill provides premium subsidies of ACA marketplace coverage equivalent to a person earning up to 133% of the federal poverty level for people who receive unemployment compensation. The bill also includes an option for states to provide one-year of postpartum Medicaid coverage, support for state home-and community-based Medicaid services, and resources for COVID-19 response in nursing homes. The bill also increases rebates that pharmaceutical companies owe to Medicaid programs, provides $8.5 billion for rural providers, provides additional funding to safety net hospitals and more.

Stay tuned for analysis of additional upcoming legislation and practice impacts by following along @Cardiology on Twitter and reading the ACC Advocate email newsletter. Get more COVID-19 resources on the ACC COVID-19 Hub here.

Clinical Topics: COVID-19 Hub

Keywords: ACC Advocacy, Coronavirus, Patient Protection and Affordable Care Act, COVID-19, Medicaid, Public Health, Health Workforce, Surge Capacity, Personal Protective Equipment, Rural Health, Contact Tracing, Medicare, Telemedicine, Centers for Disease Control and Prevention, U.S., Health Personnel, Vaccines, Postpartum Period

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