Senate approves $1.9 Trillion COVID-19 Relief Reconciliation Bill with provisions for hospitals, health systems

March 11, 2021

The American Hospital Association (AHA) released a Special Bulletin outlining the provisions affecting hospitals and health systems. The Senate voted 50-49 to approve a modified version of the American Rescue Plan Act of 2021, a $1.9 trillion COVID-19 relief package including the provisions.

The Senate-passed bill is similar to legislation approved by the House of Representatives on February 27; however, the Senate did make a number of changes. The House next week is expected to pass the Senate version without further changes, and it then would go to President Biden for his signature.

Changes in the Senate bill include additional new funding for rural hospitals and healthcare providers for COVID-19 relief; increased federal subsidies for COBRA coverage; and changes to the Medicare wage index. The Senate bill also includes provisions to bolster the nation’s COVID-19 healthcare response with additional resources for vaccines, treatment, personal protective equipment (PPE), testing, contact tracing and workforce development. Other healthcare-related provisions would provide funding to the Department of Labor for worker protection activities.

In addition, non-healthcare specific provisions would provide financial support for families and small businesses, as well as extend and expand support for housing, child care, food and the education system.

While the bill will help provide much-needed relief for rural hospitals, the association also is disappointed that it does not deliver more overall funding for the Provider Relief Fund. AHA also is concerned that the bill does not include an extension of relief from Medicare sequester cuts and fails to provide loan forgiveness for Medicare accelerated payments for hospitals.

“As the legislation moves back to the House, where passage is likely early next week, we look forward to continuing to work with Congress and the Administration on ensuring hospitals and health systems have the support, resources and tools they need to continue to provide essential services to their patients and communities during the pandemic and beyond,” Pollack said. 

The bill would provide $8.5 billion to reimburse rural healthcare providers for healthcare-related expenses and lost revenues attributable to COVID–19. Its definition of rural provider is broad and includes those that:

·        are located outside a metropolitan statistical area (MSA); or

·         are located in a rural census tract of an MSA; or

·         are located in an area designated by the state as rural; or

·         are a sole community hospital or rural referral center; or

·         are located in area that serves rural patients, such as a small MSA; or

·         are a rural health clinic; or

·         provide home health, hospice, or long-term services and supports in patients' homes that are located in rural areas; or

·         otherwise qualify as a rural provider, as defined by the Secretary. 

The bill includes a number of provisions to improve the nation’s vaccine and testing capacity. It would allocate $10 billion for the purposes of carrying out activities under the Defense Production Act. Specifically, the funding would be used for the manufacturing and procurement of medical supplies and equipment related to combatting the COVID-19 pandemic, including diagnostic products, PPE, drugs, medical devices and biological products.

It also would allocate more than $70 billion for COVID-19 vaccine, testing and workforce efforts. Specifically, more than $15 billion is geared toward enhancing, expanding and improving the nationwide distribution and administration of vaccines by supporting efforts such as increasing access, especially in underserved communities, increasing vaccine confidence and funding the research, development, manufacturing and procurement of vaccines, therapeutics and other ancillary supplies. The bill further assigns $6 billion for the research, development, manufacturing, production and purchasing of vaccines, therapeutics and other ancillary products, as well as $1 billion for efforts to boost vaccine confidence.

With respect to testing, the bill would allocate $47.8 billion to continue implementation of an evidence-based national testing strategy with a focus on components such as detection, diagnosis, tracing and monitoring. Further, $1.75 billion would be directed to support genomic sequencing and surveillance initiatives.

The bill would make changes to a number of healthcare coverage programs to expand eligibility and increase federal financial support for coverage.

In a separate section, the legislation would newly make eligible for marketplace coverage individuals who receive unemployment compensation during 2021.

American Hospital Association has the special bulletin.

More COVID-19 coverage HERE.