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Recent Federal Legislation Reflects Depth of National Response to COVID-19

March 26, 2020
Ron Manderscheid
By Ron Manderscheid, Executive Director, NACBHDD and NARMH
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

As you all are aware, the coronavirus (COVID-19) crisis has drastically changed the nature of our society literally overnight. Its effects extend not only to our very health and wellbeing, but also to our social interaction and organization, our jobs and economy, our educational systems, and our other institutional sectors. Below, I present brief overviews of the three pieces of legislation crafted by Congress in response to this crisis.

The first effort. On Feb. 25, the Trump administration requested that Congress appropriate $2.5 billion to fight the novel coronavirus, On March 6, the president signed an $8.3 billion package of emergency funding adopted by Congress. The legislation provided $7.76 billion to federal, state and local agencies to combat COVID-19 and authorized an additional $500 million in waivers for Medicare telehealth restrictions. It also included more than $3 billion for vaccine research. The measure did not contain language guaranteeing the affordability of any potential vaccine, however.

The Families First Act. On March 14, in a 363-40 vote, the House of Representatives adopted the Families First Coronavirus Response Act (HR 6201), a second multibillion-dollar legislative package to address the crisis. The measure includes some key resources for counties. The Senate followed suit on March 18 by a vote of 90-8. Just for the record, 8 senators voted against the Families First Act, arguing that it didn’t do enough for small businesses and industries hit hardest by the virus: Marsha Blackburn (Tenn.), James Inhofe (Okla.), Ron Johnson (Wis.), James Lankford (Okla.), Mike Lee (Utah), Rand Paul (Ky.), Ben Sasse (Neb.), and Tim Scott (S.C.). A number of Senate amendments were shot down, among them one that would have amped up who can get paid sick leave offered by Sen. Patty Murray (Wash.). The final bill was signed into law by the president on the same day as Senate adoption. The package includes five primary provisions:

  • Free coronavirus testing for all individuals, including those with private insurance, Medicare Advantage or Original Medicare, Medicaid, CHIP, VA, FEHBP and TRICARE, as well as the uninsured.
  • Food assistance in the form of over $1 billion to provide nutritious foods to low-income pregnant women and mothers with young children, help food banks and provide meals to seniors. It also protects students’ access to school meals in the event of school closures.
  • Medicaid Federal Medical Assistance Percentage (FMAP) rates, the funds that federal government provides to state and territorial Medicaid programs, were increased by 6.2%. It requires states to maintain eligibility standards that are no less restrictive than the date of enactment. It also maintains a special provision that preserves the existing FMAP sharing arrangements between states and their political subdivisions – a major win for counties in certain states.
  • Unemployment assistance provides both resources and flexibility to get unemployment benefits to laid off and furloughed workers, as well as to those workers who exhaust their allotted paid leave. For 2020, $1 billion is available for emergency grants to states for activities related to processing and paying unemployment insurance benefits. Of that amount, $500 million will provide immediate funding to all states for staffing, technology, systems and other administrative costs. The other $500 million is reserved for emergency grants to states experiencing at least a 10% increase in unemployment. 
  • Paid sick and medical leave is made available through an Emergency Paid Leave Program that replaces a significant share of lost wages so that those who take leave to avoid spreading the virus or due to illness or caregiving responsibilities can pay their bills. The bill requires employers with fewer than 500 employees and government employers to provide employees two weeks of paid sick leave, paid at two-thirds of the employee’s regular rate to care for a child whose school has closed, or if a childcare provider is unavailable, due to the coronavirus. This mandate expires Dec. 31. The legislation also grants employees of employers with fewer than 500 employees and government employers, who have been on the job for at least 30 days, with the right take up to 12 weeks of job-protected leave under the Family and Medical Leave Act to be used for COVID-19-related medical situations.

The stimulus package. On Wednesday, the Senate voted 96-0 to pass a $2.2 trillion stimulus package. The broad outlines are as follows:

  • $500 billion for distressed companies
  • $377 billion for small business loans
  • $250 billion for individuals and families (Checks of $1,200 will go to adults making up to $75,000, with decreasing amounts and a phase-out at $99,000, and $500 for each child.)
  • $250 billion for unemployment insurance (Amounts will be increased by $600 per month, and the length of coverage will be extended by four months.)
  • $100 billion to support hospital operations
  • $200 billion for “other domestic priorities”
  • $150 billion for state and county stimulus funds
  • $15 billion for the SNAP program
  • $17 billion for support of security industries
  • $17 billion for Boeing
  • $30 billion for emergency educational funding

Clearly, there also are other provisions in the bill that I have not been able to detail here. Among these are an estimated $450 million for extension of the federally qualified community behavioral health clinics program; changes to 42 CFR Part 2 to permit inclusion of substance use care records in electronic patient record systems; and an authorization for agencies that receive Medicaid reimbursement to participate in stimulus funding provisions.

This bill was sent to the House on Thursday, with an expected vote on Friday. Every expectation is that the House will approve this bill.

Times of crisis require bold action. Each of these three pieces of legislation reflects the depth of the coronavirus crisis and the dramatic nature of our national response.

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