March 17, 2020

Update on Coronavirus Response - Phase II


KEY TAKEAWAYS

  • The federal government continues to respond to the coronavirus, named COVID-19 by the World Health Organization.  
  • Congress provided supplemental funding to target research and development of vaccines and treatments, health system preparedness, support state and local public health departments; and to strengthen the national stockpile of medical supplies.
  • On March 14, the House passed the Families First Coronavirus Response Act, which provides aid to those affected by the outbreak and ensures people have coverage to receive diagnostic testing authorized or approved by the Food and Drug Administration. The Senate is expected to vote on the emergency funding package this week. 

On March 11, the World Health Organization officially declared the outbreak of coronavirus, officially named COVID-19, to be a global pandemic. In an effort to suppress and control the virus, the Trump administration has limited travel from China and Europe into the United States, expedited the availability of tests, and put Admiral Brett Giroir in charge of testing efforts for public health service agencies. The Food and Drug Administration also now hosts a 24-hour hotline for labs to access if they are having trouble getting authorized tests and need assistance processing tests. On March 13, President Trump declared a national emergency, allowing him to use additional funds allocated by Congress for FEMA and other federal agencies to respond to the public health emergency and assist state and local governments. The Centers for Disease Control and Prevention also recommends that, for the next eight weeks, any events of 50 or more people be canceled or postponed.

latest Response by federal Agencies

The CDC has distributed diagnostic kits to state and local public health laboratories to diagnose COVID-19 patients in the United States. The FDA granted an emergency use authorization to allow more labs to test samples and identify potential cases more quickly. As of March 16, there were 84 state and local health departments in every state, Washington, D.C., and Guam using the CDC’s COVID-19 diagnostic test. The FDA has granted authority for Roche, Thermo Fischer, and public and private labs in New York to use tests they have developed to detect coronavirus. Commercial labs such as Quest and LabCorp also have started testing.

CDC also launched a website with tips on how to prevent the spread of the disease at home, in our schools and workplaces, and throughout our communities. Along with FDA, the CDC took steps to make more protective masks available to health care workers. They can now use respirators that have been approved for other types of work, such as construction, even though they were not specifically approved for health care uses.

providing the resources to fight CORONAVIRUS

Congress provided $7.8 billion in discretionary supplemental funds to target research and development of vaccines and treatments, and to support state and local public health departments. The funding also helped to strengthen the national stockpile of medical supplies and health system preparedness and increased access to telehealth services.

On March 14, the House passed the Families First Coronavirus Response Act, H.R. 6201, by vote of 363-40. The Senate is expected to vote on the emergency funding package this week. The bill establishes, during the COVID-19 outbreak, an emergency paid leave program, increases unemployment benefits, provides food aid. It requires insurers to provide coverage for certain coronavirus testing even after the public health emergency for COVID-19 ends. Key provisions of the bill include:

COVID-19 Testing

  • Requires private health plans to provide coverage without cost sharing for COVID-19 diagnostic testing authorized or approved by the FDA as well as the cost of the visit, including a telemedicine visit.

  • Requires Medicare Advantage plans to cover COVID-19 diagnostic testing and the visit that results in the order for the test without cost sharing.

  • Waives cost sharing for Medicare beneficiaries’ doctor visits to receive or order a COVID-19 diagnostic test. Currently Medicare covers diagnostic laboratory tests with no cost-sharing.

  • Requires Medicaid and CHIP to cover diagnostic testing for COVID-19, including the cost for the provider visit, with no cost sharing. State expenses for the uninsured for diagnostic testing and the associated provider visit would be covered by the federal government through Medicaid.

  • The bill provides $1 billion to the Public Health and Social Services Emergency Fund, available until expended, to reimburse providers for diagnostic testing for people who are uninsured.

  • Classifies personal respiratory protective devices for which the FDA has issued an emergency use authorization as “covered countermeasures” under the Public Readiness and Emergency Preparedness Act until October 1, 2024. PREP allows the Department of Health and Human Services to provide liability protections for emergency countermeasure products.

  • Ensures TRICARE beneficiaries, covered veterans, and federal employees are covered for COVID-19 diagnostic testing, including the cost of the physician visit.

  • Provides the Indian Health Service $64 million to cover COVID-19 diagnostic testing and related services.

  • Each state, including the District of Columbia and U.S. territories, may receive an emergency federal medical assistance percentage increase of 6.2 percentage points for the duration of the COVID-19 public health emergency. To be eligible, states are required to provide coronavirus testing coverage with no cost sharing to beneficiaries and meet certain other requirements without placing undue burden on states to change their Medicaid operations in the middle of this crisis.

Nutrition Programs

  • $500 million for the special supplemental nutrition program for women infants and children.

  • $400 million for the emergency food assistance program, which helps states and food banks distribute food for low-income people through local agencies.

  • $250 million for nutrition programs for seniors, including home-delivered meals.

  • For fiscal year 2020, allows the secretary of agriculture to approve state plans to provide additional, temporary SNAP benefits to families with eligible children, when their schools close for at least five days in a row during a public health emergency. The amount will be based on the reimbursement value for free or reduced-price meals for each eligible child in the household.

  • $100 million for nutrition assistance grants for Puerto Rico, the Northern Mariana Islands, and American Samoa.

  • $15 million for the Internal Revenue Service’s taxpayer services or operations support activities for carrying out this act.

  • Allows the agriculture secretary to grant COVID-19 waivers for certain school meal program requirements, to ensure meals are provided despite school closures. Can waive nutritional content requirements if food supply chains are disrupted. Also allows child and adult food program centers to serve food without requiring participants to gather and eat.

  • Waives federal SNAP work requirements temporarily but maintains work training program requirements. Provides that the three-month SNAP participation limit for people who do not satisfy the work requirement will restart one month after the declared pandemic emergency has been lifted.

Coronavirus Related Leave

  • Sets up a paid sick leave requirement for employers with fewer than 500 employees to give to their employees who have the virus; are in quarantine or caring for someone in quarantine; or are caring for a child under 18 whose school is closed. Full-time workers receive 80 hours of paid sick leave, and part-time workers receive time equal to the average number of hours they work in a given two-week period. Pay is capped at $511 per day and $5,110 in the aggregate for employees with the virus or in quarantine. Pay is capped at $200 per day and $2,000 in the aggregate for employees caring for someone in quarantine or for a child whose school closed. The required sick leave and family leave are paired with a refundable payroll tax credit to cover these amounts, and the requirement ends December 31.

  • Amends the Family and Medical Leave Act to set up a temporary emergency paid leave program through December 31. Requires private employers with fewer than 500 workers and government employers to provide employees up to 12 workweeks of leave, for those who have worked at least 30 days. Applies if the employee requests leave to take care of a child under 18 whose school or day care facility is closed. The first 10 days may be unpaid but generally would be covered by the emergency sick leave requirement, or the employee could use vacation leave or other eligible paid leave for these days. For the rest of the leave, employees would be entitled to at least two-thirds of their regular pay, up to $200 per day and $10,000 total. Employers will be fully reimbursed for these amounts. Employers with fewer than 25 employees do not have to reinstate an employee who takes leave if the position no longer exists and the employer tried to put the person in a similar position. Allows the Labor Department to exempt small businesses with fewer than 50 employees from this new leave requirement if it would put them in jeopardy.

  • Provides payroll tax credits for employers required to provide emergency paid sick leave or family medical leave under the bill. The emergency paid sick leave credit provides a maximum credit of $511 per day, for up to 10 days or two weeks, for employees on leave because they have the virus or are in quarantine. If the employee is on leave to care for a child whose school or daycare closed, or to care for a person who is in quarantine or seeking medical care, the maximum credit per employee is $200 per day, for up to 10 days or 2 weeks. The payroll credit for family leave applies to leave required to be paid to employees beyond the 10 sick days, but it only covers wages paid to an employee on leave to take care of a child whose school or day care facility is closed. The family leave credit provides a maximum credit of $200 per day, up to $10,000 or 10 weeks. Both credits apply against the employer’s portion of the Social Security tax and cover 100% of wages required to be paid. Both credits are fully refundable.

  • Establishes comparable sick leave and family leave income tax credits for self-employed workers, to cover the same coronavirus-related circumstances, days of leave, and wage amounts as the employer credits. The self-employed tax credits are also 100% refundable.

  • Employers in the U.S. possessions and territories are subject to Social Security tax and therefore will be eligible for the employer tax credits on the same basis as U.S.-based employers. Special rules provide for Treasury to make payments to U.S. possessions and territories to cover the cost of administering comparable sick and family leave credits for the self-employed.

  • Provides the Treasury with broad authority to issue rules and guidance, including to help businesses manage cash flow to meet the sick leave and family leave requirements.

  • Provides that the Social Security Trust Fund and Railroad Retirement Fund are held harmless through a general fund transfer.

  • $1 billion for emergency administration unemployment insurance grants to states. The states will receive half of their funds within 60 days after meeting conditions, such as requiring employers to tell employees about UI benefits when they separate and letting people apply remotely as well as in person. States that see at least a 10% increase in unemployment claims will receive the rest of the funds. States are also given authority to make changes to their regular UI practices in light of COVID-19, such as waiving job search requirements and eliminating any waiting period.

  • Provides 100% federal funding, up from 50%, for extended unemployment benefits. These additional weeks of benefits begin when a state has a high unemployment rate and when a recipient has exhausted benefits in his or her state.

 

Issue Tags: Health Care, Economy, COVID-19