House Passes Virus Response Measure - H.R.6201

The Senate is next in line to take up a COVID-19 economic stimulus package, though at least a handful of Republican senators have complaints about its paid leave provisions.

Treasury Secretary Steven Mnuchin and Senate Majority Leader Mitch McConnell said the bill was on track in the Senate. "We're anxious to get it," McConnell said of the House's revisions. He said the Senate's plan for the House package was simply to "pass it." 

But some GOP senators have voiced concerns about the impact of the paid leave mandate on small businesses, who have lobbied lawmakers against it.

HOUSE ACTION

The House passed an economic relief plan backed by President Donald Trump to deal with the spreading coronavirus as part of what lead negotiator Speaker Nancy Pelosi said will be a continuing effort to help the American people.

The 363-40 vote early Saturday sends the measure to the Senate, which plans to skip next week’s planned recess to take up the bill. The House is not planning to be in session next week.

“I encourage all Republicans and Democrats to come together and VOTE YES!” Trump wrote on Twitter Friday after two days of intense negotiations between Pelosi and Treasury Secretary Steven Mnuchin. The president added, “Look forward to signing the final Bill, ASAP!“

The House package includes free testing for everyone who needs it, and two weeks of paid sick leave to allow people with the virus to stay home from work and avoid infecting co-workers. It also includes enhanced jobless benefits, increased food aid for children, senior citizens and food banks, and higher funding for Medicaid benefits.

The growing outbreak is beginning to squeeze the U.S. economy as schools and sports leagues shut down and businesses scale back or require employees to work from home.

Earlier Friday, Trump declared a national emergency that would free up as much as $50 billion to help states and cities respond to the health crisis, waive student-loan interest, purchase large quantities of oil and confer new authority on his health secretary to bypass hospital regulations.

H.R.6201 BILL SUMMARY

The bill provides funding for various assistance programs in response to the growing coronavirus pandemic. The measure establishes a program to provide sick and quarantined workers with two weeks of emergency paid leave, requires employers to provide additional sick days to their employees, and provides $1 billion in grant funding to help states manage and expand their unemployment insurance programs during the COVID-19 crisis. The bill also provides funds for free coronavirus testing; enhanced food security initiatives, including SNAP, student meals, seniors nutrition and food banks; additional protections for frontline workers, including health care workers and others who are in contact with those who have been exposed or are responsible for cleaning at-risk places; and additional federal funding for Medicaid. 

BACKGROUND: The Appropriations, Education and Labor, Ways and Means, Agriculture, and Energy and Commerce committees did not act on the measure which was introduced March 11 by Chairwoman Nita M. Lowey, D-N.Y.

More than 120,00 people worldwide have been diagnosed with COVID-19, the respiratory illness caused by the novel coronavirus first identified in January in Wuhan, China. The virus, which has now been confirmed in more than 108 countries, has officially been declared a pandemic by the World Health Organization and has led to roughly 4,200 deaths worldwide.

While more than 80% of reported cases are mild, the pathogen is highly infectious and can be spread even by those with mild or no symptoms, which has made it difficult to track and contain. Common symptoms include dry cough, shortness of breath and fever, while severe COVID-19 infections can cause pneumonia and can lead to death. Most at risk for severe infections are the elderly and those with underlying health conditions, such as heart or lung issues, diabetes, and compromised immune systems.

While two-thirds of confirmed cases are in China, most of the new cases reported in the past three weeks have occurred in other countries, including the United States. As of March, the largest outbreak of COVID-19 outside of China is in Italy, with more than 10,000 confirmed cases and more than 600 deaths. Other large outbreaks are ongoing in South Korea and Iran.

In the United States, more than 1,000 cases of coronavirus infections have been confirmed in 38 states as of March 11, though public health experts have been warning that more cases have likely gone undiagnosed due to testing delays. While many of these patients recently returned from countries with COVID-19 outbreaks, local transmission is increasing, possibly threatening health care capacity in those areas.

At present, 31 people have died from COVID-19, mostly in Washington state, the site of the largest outbreak in the United States. Other deaths have occurred in California, New Jersey, and Florida.

Global Impact and Response

In addition to health concerns, COVID-19 has also caused widespread economic and social disruptions. During the peak of the outbreak, commercial activity in Wuhan and other Chinese cities effectively ceased, with quarantines and travel restrictions shutting down factories and creating worker shortages. The restrictions have disrupted international supply chains by reducing exports of pharmaceuticals, textiles, electronics, other manufactured goods, and raw materials that are provided by China.

Fear of contracting the virus has especially harmed the global tourism industry, and corporate decisions to scale back business travel has negatively impacted airlines and hotels as well. Concerns about the virus have also led to panic buying and subsequent shortages of medical supplies, such as masks.

The rapid spread of COVID-19 beyond East Asia in late February has sparked concerns about a much longer, broader and deeper economic disruption and the possibility of a global recession — concerns that have led to steep drops in stock markets around the world. On March 9, the New York Stock Exchange briefly suspended trading after key indices, the S&P 500 and the Dow Jones Industrial Average, dropped by more than 7%, the largest single-day drop since the 2008 financial crisis.

Some nations and local jurisdictions have discouraged people from congregating together where virus transmission could occur, which has led to the cancellation of numerous events, sports competitions being held in empty stadiums, and the closing of schools. The Italian government this week placed travel restrictions across the entire country of 60 million people, prohibiting large gatherings at weddings, closing schools, and limiting business hours where possible.

Some public health experts have already begun to call for similar "social distancing" practices in the United States to reduce the virus's transmission rate. This week, Washington state began restricting gatherings of more than 250 people in the Seattle area, while the District of Columbia is urging the cancellation of conferences, conventions, and any entertainment events where large crowds are anticipated. While social distancing, such as teleworking and avoiding large events, can help reduce the spread of coronavirus, these steps can further disrupt parts of local economies, especially the service and hospitality sectors. For example, many restaurant owners in Seattle have reported a 50% to 70% decline in business in the past two week. Cancelled conventions and other large events, such as the South by Southwest Festival in Austin, are hurting vendors, restaurants, and hotels in the surrounding areas.

Moreover, teleworking or using limited sick time to self-quarantine might not be an option for many workers, while hourly workers and contractors might have to choose between going to work sick (and possibly spreading coronavirus) or staying home, forgoing wages and possibly losing their jobs. Wage workers and gig workers could face similar pressure if slumping demand leads to shift cancellations or, in some instances, layoffs.

If schools begin to close due to coronavirus in large numbers, child care could also become a serious concern for working parents. According to Education Week, more than 1,200 schools have either closed are expected to close in the coming days. School closures could also harm students from lower income families who rely on federal school lunch programs for meals.

Federal Response

As both the larger economy and smaller business have begun to feel the impact from COVID-19, many lawmakers have begun calling for broader legislation to help communities respond to the economic disruption accompanying the virus. This week, the White House called for a payroll tax cut to help businesses affected by economic contractions. Many Democratic lawmakers, however, have argued that a payroll tax would not help the small businesses and individual workers that are likely to be the most impacted by COVID-19 and any accompanying recession. Instead, they have called for an expansion of unemployment insurance and disaster grants to help businesses at the local level, as well as food and housing assistance for low-income individuals.

Last week lawmakers passed an $8.3 billion emergency supplemental appropriations measure (PL 116-123) to support federal efforts to contain and address the coronavirus, including supporting research into treatments, and helping state and local health agencies respond to the virus.

Meanwhile, on Wednesday night President Donald Trump used a primetime address from the Oval Office to announce sweeping new restrictions on travel from Europe, effectively prohibiting most flights from continental Europe to the United States for 30 days. He called on Congress to pass economic stimulus legislation that included his payroll tax cut, and said he'd use executive powers to "provide financial relief" for quarantined workers and those forced to stay home without pay to take care of ill family members or children as a result of the pandemic. He also said he'd allow deferred tax payments for "certain individuals and businesses" in order to inject a temporary infusion of $200 billion into the economy, and urged lawmakers to expand small business loan authority by an additional $50 billion.

Following the president's address, House Democrats introduced their own economic stimulus package which did not contain the president's proposed payroll tax holiday. Instead, their bill contained a series of provisions targeting direct aid to individuals and small businesses. It also included paid sick leave, extended unemployment insurance, expanded food aid to low-income families, coverage to ensure free testing and treatment and additional small business loans.

SUMMARY: This bill authorizes and provides additional funding for various assistance programs to support the federal response to the coronavirus pandemic and assist workers facing economic hardship as a result of the virus.

Specifically, it establishes a program to provide sick and quarantined workers with two weeks of emergency paid leave, requires employers to provide additional sick days to their employees, and provides $1 billion in grant funding to help states manage and expand their unemployment insurance programs during the COVID-19 pandemic.

It appropriates $1.2 billion to the Agriculture and Health and Human Services Departments to provide additional nutrition assistance to affected areas and populations, including low-income seniors and their caregivers, local food banks, pregnant and postpartum women, and students who lose access to school lunch programs as a result of COVID-19-related school closures. It also grants states additional flexibility in providing nutrition aid under the Supplemental Nutrition Assistance Program (SNAP) and the Child Nutrition Program.

Additionally, the measure requires private health plans to cover diagnostic testing for COVID-19 at no cost to consumers. Finally, it requires the Occupational Safety and Health Agency (OSHA) to establish new workplace safety standards to better protect health care workers and other front-line caregivers from coronavirus infections.

The measure's funds are designated as emergency spending and are therefore not subject to regular discretionary budget caps.

Paid Sick Days

The United States is the only industrialized nation in the world that does not require employers to provide paid sick leave to full-time workers. Although various states and municipalities have mandated paid sick leave, the coverage is uneven.

The Centers for Disease Control and Prevention (CDC) recommends that anyone who is sick should stay home from work so as to contain the spread of disease, including COVID-19. Individuals who have been exposed to someone who tests positive for COVID-19, or who test positive themselves are asked to self-quarantine at home for 14 days, even if they are not experiencing any symptoms. Low-wage workers are the least likely to have paid sick leave even though they often are often in positions that interact significantly with the public. As a result, when these workers get sick, they simply cannot afford to take unpaid time off and fear losing their jobs if they do so.

The bill requires employers to offer at least seven paid sick days to their employees and creates a new federal paid sick leave benefits program to extend emergency leave pay to individuals in the event of a public health emergency.

Employer-Provided Sick Leave

Specifically, the measure requires all employers to grant seven days of sick pay and an additional 14 days during the event of any public health emergency (including the current COVID-19 crisis).

The sick leave required under the bill could be used when an employee's child's school is closed due to a public health emergency, when the employer closes, or if an individual or family member is quarantined or isolated due to a public health emergency.

The bill reimburses small businesses (defined as a business with 50 employees or fewer) for the cost of providing the additional 14 days that must be offered during a public health emergency. Under the measure, construction workers who are paid based on the hours they work for multiple contractors would be permitted to receive sick pay based on the total hours they work.

Finally, the measure appropriates $5 million for the Labor Department to administer the employer sick leave program.

Emergency Leave

The bill creates a new emergency paid leave benefits program within the Social Security Administration to provide emergency leave days to individuals affected by the COVID-19 pandemic.

Under the measure, if a worker is required to take more than 14 days off work due to the COVID-19 virus, he or she is eligible for a monthly benefit payment of two-thirds of his or her average monthly salary (up to $4,000 per month). Benefits are reduced dollar-for-dollar by the amount of any state or private paid leave benefit the individual may receive. (States that make offset payments will be reimbursed by the federal government if they are due to state-run or state-mandated paid leave programs).

The benefit covers a worker who has contracted the virus, anyone who is quarantined at the instruction of a health care provider, employer or government official, a worker caring for someone else who has contracted COVID-19, or a worker who is caring for a child or other individual who cannot care for themself due to a virus-related closing, such as a school or child care facility.

The program will be in effect for one year beginning with the first diagnosis of the disease in the United States on Jan. 19, 2020. Benefits may be filed retroactively and can be accepted for up to six months after enactment. Individuals who use this benefit will have their existing benefit rights protected, including any rights to state or local leave benefits.

These benefits do not count as income or resources for the Supplemental Security Income (SSI) program.

Testing Costs and FMAP Increase

The tests for COVID-19 are new and may not be covered by all health insurance plans. Low-income individuals, especially if they are not experiencing any symptoms, may be unwilling to seek testing if they think they will be charged for the procedure, according to health care experts.

The Trump administration announced on March 4 that COVID-19 testing would be fully covered for all patients under the Affordable Care Act, but some members of Congress have noted that the administration does not have the authority to enforce this requirement for most health insurance plans. On March 5 the Centers for Medicare and Medicaid Services issued guidance on COVID-19 coverage and benefits for Medicaid, CHIP, and health insurance plans purchased on the government exchanges. The guidance noted that these plans vary by state and recommends that individuals look up the coverage in their state. Medicare Part B will cover testing for COVID-19.

Diagnostic Testing Costs

The bill requires government and private health plans to cover COVID-19 diagnostic testing.

Specifically, it requires private health plans, Medicare Advantage Plans, TRICARE, veterans plans, federal workers' health plans, and the Indian Health Service to cover, at no cost to the patient, the COVID-19 diagnostic test, and a provider, urgent care center, or emergency room visit in order to receive testing.

For Medicare Part B beneficiaries, the bill requires patient's provider visits when a COVID-19 diagnostic test is administered or ordered to be covered by the program free of charge to the individual. COVID-19 diagnostic testing is already covered by Part B.

The measure also waives all costs for COVID-19 testing, including the cost of a provider visit to receive a test, for Medicaid and Children's Health Insurance Plan (CHIP) beneficiaries.

 It also permits states to extend Medicaid eligibility to their uninsured populations for the purpose of COVID-19 diagnostic testing. State costs for medical and administrative costs would be matched by the federal government under the bill.

Finally, the measure requires the National Disaster Medical System to reimburse the costs of COVID-19 diagnostic testing to the uninsured. (Run by the Health and Human Services Department, the program supplements health and medical systems and response capabilities providing federal health resources when state and resources are overwhelmed.)

FMAP

The Federal Medical Assistance Percentages (FMAPs) are used in determining the amount of federal matching funds for state expenditures for assistance payments for certain social services, as well as state medical and medical insurance expenditures.

The measure increases by 8% during the COVID-19 emergency the FMAP matching assistance the federal government provides to states during the emergency. To be eligible, states must maintain program eligibility standards that are no less restrictive than at the date of enactment.

Respirators

The Public Readiness and Emergency Preparedness (PREP) Act permits HHS to issue a declaration that provides immunity from tort liability for claims of loss caused by countermeasures (i.e., vaccines, drugs and products) against diseases or other threats of public health emergencies.

The measure also requires personal respiratory protective devices to be covered under the PREP act during the COVID-19 emergency. The emergency declaration for respirators will expire on Oct. 1, 2024.

Nutrition Assistance

Child Nutrition Programs

The National School Lunch Program, the School Breakfast Program, the Child and Adult Care Food Program, and the Summer Food Services Program provide nutritious foods to preschool children and children in elementary and secondary schools. These programs are able to provide meals to children who are not in school during unanticipated school closures. Normally these meals would be offered at school cafeterias and non-school sites in a communal setting where everyone sits down to eat together, although the coronavirus may force program operators to avoid such congregations.

The bill authorizes the Agriculture Department to provide additional nutrition assistance to families with children who are eligible but unable to receive free or reduced-priced meals because their schools are closed for more than five days due to the COVID-19 emergency. Under the measure, the department must approve state plans for temporary eligibility standards for affected households. The state agency administering the emergency nutrition assistance may provide the additional funds through the EBT card system, a part of the Supplemental Nutrition Assistance Program (SNAP, commonly referred to as food stamps).

If social distancing is recommended to avoid the spread of COVID-19, the measure allows states to request a waiver that allows meals to be provided in a non-congregate setting. The bill allows the Agriculture Department to grant a waiver that increases the federal cost share of a state's school lunch program.

The measure authorizes USDA to grant waivers allowing child and adult care centers to provide meals and snacks under the National School Lunch in a non-congregate or non-group setting. It also authorizes USDA to waive nutrition requirements if the COVID-19 emergency begins to cause supply chain disruptions that affect the food supply. States issued these waivers are required to submit to the department a report on how the waiver impacted services. These waivers may not be issued after Sept. 30, 2020.

SNAP Benefits

 The Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) currently helps feed over 34 million people. To help increase access to the program, the measure authorizes USDA to provide additional funds to state agencies to make emergency allotments to households participating in SNAP. These emergency allotments may not exceed a household's maximum monthly allotment.

The measure authorizes the department to issue flexible requirements for state programs to be consistent with conditions in areas affected by COVID-19 and suspends work and work training requirements for SNAP recipients.

The bill also provides $100 million for nutrition assistance grants to Puerto Rico, the Northern Mariana Islands, and American Samoa for their territorial nutrition assistance programs to help respond to COVID-19 outbreaks.

Other Nutrition Assistance Programs

 The bill appropriates $500 million to the Supplemental Nutrition Program for Women, Infants, and Children (WIC). The program provides assistance to children up to five years of age and to pregnant, postpartum, and breast-feeding mothers who are at risk from inadequate nutrition. Appropriators say this additional funding will help pregnant women and new mothers who are laid off or are unable to work during the COVID-19 emergency.

The bill also provides $400 million to the USDA Commodity Assistance Program for emergency food assistance, which helps USDA purchase and provide foods to elderly and low-income individuals. Of the amount appropriated, $100 million is to support the storage and distribution of foods to food banks and other programs. The measure also authorizes the department to purchase commodities for emergency distribution in any area of the United States during a public health emergency.

    These funds would remain available through the end of FY 2021.

In addition, the bill provides $250 million to the Health and Human Services Department for the Senior Nutrition Program. This program provides grants to states and territories to deliver pre-packaged meals to low-income seniors who are home-bound, have disabilities, or have chronic illness. The program helps caregivers of homebound seniors and currently provides funding to organizations that serve more than 2.4 million people each year.

According to appropriators, the additional funding will help provide an additional 25 million meals to seniors relying on the program, the number of which may increase due to COVID-19-related social distancing.

Unemployment Insurance

The bill provides $1.0 billion in 2020 for emergency grants to states for activities related to processing and paying unemployment insurance (UI) benefits.

The total includes $500 million to provide immediate additional funding to all states for staffing, technology, systems, and other administrative costs, so long as they met basic requirements about ensuring access to earned benefits for eligible workers. The measure requires states to report on the share of eligible individuals who received UI benefits and the state's efforts to ensure access.

The measure also provides $500 million for emergency grants to states which experienced at least a 10% increase in unemployment. Those states would be eligible to receive an additional grant, in the same amount as the initial grant, to assist with costs related to the unemployment spike.

    The measure also does the following:

•     Extended Unemployment Compensation — For states that experience an increase of 10% percent or more in their unemployment rate over the previous year, the bill provides 100% federal funding for Extended Benefits. Extended Benefits, which normally require 50% of funding to come from states, are triggered when unemployment is high in a state and provide up to an additional 26 weeks after regular UI benefits (usually 26 weeks) are exhausted.

•     Subsidized UI — Provides states with access to interest-free loans to help pay regular UI benefits through Dec. 31, 2020.

•     Ease Eligibility Requirements — Requires states to take steps to temporarily ease eligibility requirements that might be limiting access to UI during the COVID-19 outbreak, including work search requirements, required waiting periods, and requirements to increase employer UI taxes if they have high layoff rates.

•     Work Sharing — Requires the Labor Department to provide technical assistance to states that want to set up work-sharing programs in which employers reduce hours instead of laying employees off. Employees would also receive partial unemployment benefits to offset the wage loss.

Health Care Worker Protections

As COVID-19 spreads, frontline health care workers are at increased risk of infection, placing even greater strains on the nation's health care infrastructure. Experts claim that the lack of a clear standard of protection means many health care facilities are taking insufficient steps to protect their workers. In 2009, the Occupational Safety and Health Administration (OSHA) began work on standards to protect health care workers from SARS, another coronavirus-caused disease. However, this OSHA rulemaking was suspended in 2017.

The bill directs OSHA, within one month of enactment, to issue emergency temporary standards to protect health care workers and other high risk workers from occupational exposure to SARS-CoV-2, the novel coronavirus that causes COVID-19. The measure also requires OSHA to publish a standard permanent rule within six months.

The standards issued under the measure must be based on the 2009 standards established to prevent the spread of SARS. The standards must also require employers to develop a comprehensive infectious disease exposure control plan and provide more protection than existing OSHA-approved state plans for reducing exposure to infectious pathogens.

Finally, the bill requires hospitals and skilled nursing homes operated by state or local government agencies, which are not subject to OSHA requirements, to comply with the OSHA standard developed under the bill in order to receive Medicare funds. A facility which does not comply with these standards would be subject to a civil monetary fine (though it would not lose Medicare funding).

Funding Reports

The bill requires the Agriculture, Labor and Homeland Security departments to report detailed funding uses for the money appropriated in the measure, including estimated personnel and administrative costs.