Policy Playbook: Paycheck Protection Program and Health Care Enhancement Act

Author: Summer Chavez, DO, MPH, MPM (Health Policy Fellow, Georgetown University/Medstar) // Reviewed by: Alex Koyfman, MD (@EMHighAK); and Brit Long, MD (@long_brit)

On April 24, 2020, the Paycheck Protection Program and Health Care Enhancement Act (H.R. 266) was signed into law.¹The Paycheck Protection Program and Healthcare Enhancement Act is the fourth bill passed directly addressing coronavirus.² The three prior bills include:²

1. Coronavirus Preparedness and Response Supplemental Appropriations Act

2. Families First Coronavirus Response Act

3. Coronavirus Aid, Relief, and Economic Security (CARES) Act

The bill is split into two divisions, with Division A geared towards strengthening the Small Business Administration’s Paycheck Protection Program with additional funds ($321 billion) and increasing the authorization for Economic Injury Disaster Loans ($10 billion).³ Division B is more relevant for healthcare providers and will be the focus of this month’s policy post.

Division B allocates $75 billion through the Department of Health and Human Services as part of the Public Health and Social Services Emergency Fund for reimbursement to healthcare providers for additional costs or expenses incurred due to COVID-19.^1,3 An additional $25 billion is to be allocated for novel coronavirus testing costs—including analysis, purchasing and development.^1,3 These funds may also be used towards surveillance and contact tracing.¹ A more detailed distribution is as follows:^1,4

• $11 billion for States, local governments, tribal organizations, health service providers, etc. for testing, surveillance and other related activities. An additional $4.25 billion will be given based on relative number of cases.
• $750 million to the Indian Health Service to provide care.
• $1 billion to the Centers for Disease Control and Prevention (CDC) for expansion of testing, public health activities, surveillance, improvement of testing, etc.
• Approximately $1.8 billion to the National Institutes of Health (NIH) to develop point-of-care and serologic testing, additional research activities and partnerships.
• $1 billion to the Biomedical Advanced Research and Development Authority for research and development of testing and associated supplies.
• $22 million to the Food and Drug Administration (FDA) for testing and other related activities.
• $825 million for grants to federal qualified health centers (FQHCs) and rural areas for testing.
• Up to $1 billion in funds to cover COVID-19 testing of uninsured individuals.

Most recently, the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES Act) H.R. 6800) was passed by the House on May 15, 2020 by a vote of 208-199.⁵ It currently is in the Senate and final outcome remains to be seen.⁵ An ambitious piece of legislation, it provides additional emergency appropriations, extra funds to governments, more individual stimulus payments, expands governmental assistance programs, increases funding for the Paycheck Protection Program, premium pay for essential workers, funding for contact tracing, tax credits, removes cost-sharing for treatment, modifies rules regarding foreclosures and evictions, and implements employer infectious disease control plans amongst other proposals.⁵

It’s more important than ever to stay informed and stay involved in the advocacy process.

References

1. McCollum B. Text – H.R.266 – 116th Congress (2019-2020): Paycheck Protection Program and Health Care Enhancement Act. Published April 24, 2020. Accessed May 24, 2020. https://www.congress.gov/bill/116th-congress/house-bill/266/text
2. Kellie Moss. The Paycheck Protection Program and Health Care Enhancement Act: Summary of Key Health Provisions. Kaiser Family Foundation. Published May 1, 2020. Accessed May 24, 2020. https://www.kff.org/coronavirus-covid-19/issue-brief/the-paycheck-protection-program-and-health-care-enhancement-act-summary-of-key-health-provisions/
3. Congressional Budget Office. H.R. 266, Paycheck Protection Program and Health Care Enhancement Act. Congressional Budget Office. Published April 22, 2020. Accessed May 24, 2020. https://www.cbo.gov/publication/56338
4. American Medical Association. Summary of the Paycheck Protection Program and Health Care Enhancement Act (COVID 3.5). American Medical Association. Published April 24, 2020. Accessed May 24, 2020. https://www.ama-assn.org/delivering-care/public-health/summary-paycheck-protection-program-and-health-care-enhancement-act
5. Lowey NM. H.R.6800 – 116th Congress (2019-2020): The Heroes Act. Published May 21, 2020. Accessed May 24, 2020. https://www.congress.gov/bill/116th-congress/house-bill/6800