March 23, 2020

Senate coronavirus relief package stumbles as US coronavirus cases surpass 30K

Daily Briefing

    Senate Republicans' nearly $2 trillion economic relief package failed to garner enough votes to move past a procedural hurdle on Sunday, as Democrats raised concerns that the package would not do enough to help workers who are laid off as a result of the new coronavirus epidemic in the United States.

    March 26 webinar: COVID-19: What you need to know in 45 minutes

    As US COVID-19 cases rise, NYC becomes 'epicenter' of global pandemic

    Lawmakers are working on the economic relief package as the number of reported cases of COVID-19, the disease caused by the new coronavirus, surged over the weekend—with New York City becoming an epicenter of the global COVID-19 pandemic.

    As of Monday morning, officials had reported 341,500 cases of COVID-19 globally and 15,187 deaths related to the new coronavirus. In the United States, state and federal officials had reported 33,018 cases of COVID-19 in the country—up from 12,392 cases as of Friday morning. Officials as of Monday morning also had reported 428 deaths linked to the new coronavirus in the United States, up from 195 as of Friday morning.

    According to the New York Times, there are a particularly high number of COVID-19 cases in New York City, with officials reporting thousands of new cases in the city each day and dozens of new deaths related to the new coronavirus over the past week. New York City as of Sunday accounted for about 5% of the total number of COVID-19 cases reported worldwide, making it an "epicenter" of the global pandemic, the Times reports.

    Senate GOP relief package stumbles

    Senate Majority Leader Mitch McConnell (R-Ky.) on Friday unveiled an updated version of a nearly $2 trillion economic stimulus package that includes some key health care provisions and would provide cash payments to Americans and funding for businesses in an effort to curb the economic effects of the COVID-19 epidemic. The proposal is considered the third step in Congress' three-step legislative plan to address the effects of the epidemic in the United States.

    Health care provisions

    The proposal includes provisions intended to expand testing for COVID-19, encourage the development of new vaccines and treatments for the disease, and increase the health care workforce. For instance, the legislation would allocate $14.4 billion for medical services at the Department of Veterans Affairs, $4.5 billion for CDC, and $12.7 billion in public health emergency funding. The legislation also would provide $75 billion to help support hospitals and other providers to maintain and expand their services in response to the COVID-19 epidemic.

    The proposal also would provide $1.32 billion in supplemental funding for community health centers for prevention, diagnostic, and treatment efforts related to COVID-19; create a 20% add-on payment for hospitals treating inpatients with COVID-19; allow the HHS secretary to create and implement a new payment regulation for rural and federally qualified health centers that provide telehealth services to certain patients; and loosen certain telehealth restrictions.

    Further, the proposal would temporarily suspend requirements that home dialysis patients see their physicians in person and would suspend Medicare sequester cuts from May 1 to Dec. 31, though it would extend the sequester cuts for a year past their current end date. The measure also would extend funding for certain Medicare programs that is set to expire on May 22 and delay cuts to disproportionate-share hospital payments that are scheduled to take effect May 22.

    According to Department of Treasury (DOT) Secretary Steven Mnuchin, hospitals would receive about $110 billion under the measure.

    Economic stimulus proposals

    In addition, the proposal includes $250 billion for the federal government to provide direct payments to eligible Americans and calls for loan guarantees totaling $8 billion for cargo air carries, $50 billion for passenger air carriers, $17 billion for companies that are deemed critical to national security, and $350 billion to help small businesses avoid layoffs. The proposal would provide nearly $500 billion in additional funding for the DOT to make loan guarantees or investments available to businesses, states, and localities.

    The proposal also would alter a provision enacted last week that requires small businesses to provide workers affected by COVID-19 with paid leave by limiting the amount employers must pay workers to $200 per day. In addition, the legislative package would extend 39 weeks of unemployment insurance to certain workers, retroactive to Jan. 27, and includes increased funding for certain food-assistance and nutrition programs.

    Why progress stalled

    Senators had been working toward holding a final vote on the legislative package on Monday but, on Sunday, the measure failed to garner enough votes on a procedural motion to proceed with considering the bill. According to Axios, Democrats in the Senate did not vote to move forward with the bill because of concerns that the measure does not do enough to protect workers who are laid off as a result of the COVID-19 epidemic, does not provide enough money for local and state governments and hospitals, and gives too much power to the DOT.

    McConnell said he will work with Democratic leaders in the Senate and White House officials to reach a deal on the package that will garner enough votes for approval. According to the Times, a spokesperson for Senate Minority Leader Chuck Schumer (D-N.Y.) said Schumer was confident lawmakers would reach an agreement on the measure within the next 24 hours.

    Meanwhile, after a meeting with McConnell this weekend, House Majority Leader Nancy Pelosi (D-Calif.) said House Democrats soon would introduce and pursue their own economic relief package that is "compatible with what [lawmakers] discussed in the Senate."

    Trump admin takes further action to support providers, states

    Meanwhile, the Trump administration over the weekend took further action to help support providers and states respond to the nation's COVID-19 epidemic.

    CMS on Sunday announced that it is delaying and easing certain reporting requirements for clinicians participating in some of the agency's reporting programs, including the 1.2 million providers participating in Medicare's Quality Payment Program. According to Modern Healthcare, CMS eliminated some reporting requirements for the first six months of this year and altered corresponding payment adjustments. For example, CMS said clinicians participating in the Merit-based Incentive Payment System (MIPS) who have not submitted data under the program by April 30 will receive neutral payment adjustments for the 2021 MIPS payment year.

    CMS Administrator Seema Verma said, "In granting these exceptions and extensions, CMS is supporting clinicians fighting coronavirus on the front lines" by "cutting bureaucratic red tape so the health care delivery system can direct its time and resources toward caring for patients."

    In addition, President Trump on Sunday said the federal government is providing states with additional resources to support their COVID-19 responses, such as funding 100% of National Guard efforts in California, New York, and Washington, which have reported especially high numbers of COVID-19 cases. National Guard troops in those states are helping to construct temporary medical facilities to expand the numbers of hospital beds the states have available to treat patients.

    Trump also said the federal government will ship medical supplies to states in need, including tens of thousands of pieces of personal protective equipment from the federal government's emergency stockpile. According to the Wall Street Journal, Trump on Friday announced that he has begun using his powers under the Defense Production Act "to help the states get things they need like masks and ventilators," though he did not provide details on how he using those powers.

    Trump on Sunday said he will reevaluate the federal government's response to the country's COVID-19 epidemic after the end of a 15-day period that began on March 16, when his administration had issued new guidance on social distancing for Americans (Treene, Axios, 3/23; McKinley, New York Times, 3/23; New York Times, 3/23; Saldivia, NPR, 3/22; Hauck, USA Today, 3/22; Cirruzzo/Martin, Inside Health Policy, 3/22 [subscription required]; Cochrane et al., New York Times, 3/22; Cowan/Alper, Reuters, 3/22; Werner et al., Washington Post, 3/22; Andrews/Wise, Wall Street Journal, 3/22; Aguilar, Modern Healthcare, 3/22; CMS release, 3/22; Samuels, The Hill, 3/22; Restuccia/Armour, Wall Street Journal, 3/20).

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