Bill an Important First Step, But More Needs To Be Done

Derek Thomas, Senior Fiscal Policy Analyst

Early Saturday morning, the U.S. House of Representatives passed comprehensive legislation that will begin to ease the economic hardships Americans are facing right now as a result of the developing coronavirus crisis. However, as of Tuesday afternoon, the Senate has yet to act.

The Families First Coronavirus Response Act provides free coronavirus testing, increases funding for states’ Medicaid costs, strengthens food security initiatives, enhances unemployment insurance, and provides paid sick leave and paid family and medical leave through refundable payroll tax credits.

The U.S. House deserves recognition for acting swiftly on what’s being referred to as Phase Two of their response – Phase One being the $8.3 billion spending package that focused on tests, treatment, vaccines, and telehealth provisions – while simultaneously working on the details of Phase Three.

However, as of Tuesday afternoon, the Senate has yet to act. We will continue to monitor and update this post and share additional opportunities to take action.

A Few Concerns

The Act is enormously important, but it’s only a first step. Advocates are rightly concerned about, but not limited to, the following:

• The bill reduces the state’s Medicaid share by 6.2 percentage points, meaning New York will now pay 43.8 percent of costs instead of 50 percent. However, this may prove to be insufficient given the extent to which the state budget will be squeezed by falling tax revenue and increasing costs;
• A paid leave provision that focused on survivors of domestic violence, sexual assault, and stalking and their leave was stripped from the bill, and; the Act does not ensure that caregiving covered by both paid sick days and paid leave includes all caregiving for adults and children with disabilities;
• The revised version of the Act only provides paid family leave of up to 12 weeks to people taking care of kids who aren’t in school. In the original version, all workers who received paid sick time would have been eligible for another 10 weeks of paid leave at two-thirds pay;
• The Act does not provide resources to shelter providers to quickly and permanently house people who are homeless and at high risk of infection;
• Workplace safety standards for health care workers were scrapped by industry lobbyists;
• Food assistance benefits through the Supplemental Nutrition Assistance Program (SNAP) should be increased across the board as they were in response to the Great Recession;
• Although the Act ensures access to free coronavirus testing, even for the uninsured, the legislation does not address treatment costs for the uninsured, and those with private insurance may face complications in the event of hospital bed shortages, and;
• While the bill address nutrition assistance for older adults, but does not address health insurance affordability and access to home and community-based services to reduce the risk of infection.

Fiscal Policy

With the nation’s economic centers nearly closed, business grinding to a halt across the nation, and the stock market continuing to plunge, the coronavirus outbreak is extremely likely to result in a recession. Indeed, both parties and the Trump administration acknowledge that Phase Two is merely a first step.

As such, Phase Three must enact bold fiscal policy measures to stave off a severe economic calamity and address the shortcomings in the Families First Act.

On fiscal policy, the president continues to press for his payroll tax cut. But that relief would be too slow, not well targeted, and too narrow – nearly two-thirds of the tax cut (65 percent) would go to households in the top 20 percent. While meaningful differences in the details exist, U.S. Senator Mitt Romney joined progressives policy experts in calling for rebate or “stimulus” checks for unemployed and employed Americans that would put money into peoples’ hands quickly.

What Can You Do?

Right now, the Senate must pass the Families First Act to provide relief immediately. Moving forward, the measures that the President are proposing provide a critical opportunity to address the aforementioned concerns by pressing for major provisions on UI, SNAP, more state fiscal relief, housing, and more.

Thanks to MomsRising for setting up easy ways to reach the Senate to ask them to pass the Families First Act and do more.

You can text COVID19 to 747464 or call 1-844-633-2048.

Here is a sample message you can deliver:

“Hello, my name is [your name] and I am from [city/town]. Please tell Senator [name] to vote immediately for the House coronavirus response bill AS IS. It protects people most in need and so protects all of us. Immediate paid sick leave, unemployment insurance, nutrition aid, more Medicaid funds for states, free testing and treatment, and protections for health care and other workers are essential. The House bill is a necessary start — you must do more in the coming days, such as expanding unemployment insurance, preventing eviction, providing more state fiscal relief and nutrition aid, and other timely and targeted assistance to low- and middle-income households to help minimize the economic damage from the virus. But in the meantime, please vote for the House package now.”

To receive regular updates, you can join the NY Federal Tax and Budget Response Team’s monthly calls beginning April 1st, and sign up for email alerts here.

What’s in the Bill?

By Monday evening, the House sent to the Senate a significant rewrite of the emergency coronavirus bill, which we will update here.

COVD19 TESTING

• Reimbursement for Diagnostic Testing and Services for COVID-19 in Uninsured Individuals —Includes $1 billion for the National Disaster Medical System to reimburse the costs of COVID19 diagnostic testing and services provided to individuals without health insurance.
• Coverage of Testing for COVID-19 – Requires private health plans to provide coverage for COVID-19 diagnostic testing, including the cost of a provider, urgent care center and emergency room visits in order to receive testing. Coverage must be provided at no cost to the consumer.
• Coverage of Testing for COVID-19 through the Veterans Health Administration – $60 million for the Department of Veterans Affairs to cover the costs of COVID-19 diagnostic testing for veterans receiving care through Medical Services or through Medical Community Care.
• No Cost Sharing Under the Medicare, Medicare Advantage Program, and Medicaid and CHIP for Testing For COVID-19 – This section requires Medicare Part B to cover beneficiary cost-sharing for provider visits during which a COVID-19 diagnostic test is administered or ordered (Medicare Part B currently covers the COVID-19 diagnostic test with no beneficiary cost-sharing); Medicare Advantage to provide coverage for COVID-19 diagnostic testing, including the associated cost of the visit in order to receive testing (coverage must be provided at no cost to the beneficiary); and requires Medicaid to provide coverage for COVID-19 diagnostic testing, including the cost of a provider visit in order to receive testing. Coverage must be provided at no cost to the beneficiary. It would also provide states with the option to extend Medicaid eligibility to uninsured populations for the purposes of COVID-19 diagnostic testing. State expenditures for medical and administrative costs would be matched by the federal government at 100 percent
• Medicare Telehealth – Ensures that new Medicare beneficiaries are able to access telehealth services.
• Treatment of Personal Respiratory Protective Devices as Covered Countermeasures – Requires certain personal respiratory protective devices to be treated as covered countermeasures under the PREP Act Declaration.
• Application with Respect to TRICARE, Coverage for Veterans, and Coverage for Federal Civilians – This section ensures that individuals enrolled in TRICARE, covered veterans, and federal workers have coverage for COVID-19 diagnostic testing without cost-sharing.

MEDICAID COST SHARING

• Raise the Federal Medicaid Matching Rate (FMAP) by 6.2 Percentage Points – Provides a temporary increase to states’ federal medical assistance percentage for the duration of the public health emergency for COVID-19. New York’s current federal-state split is 50-50, so a 6.2 percentage point increase means the federal government will now pay 56.2 percent and the state would pay 43.8 percent. This would deliver roughly $6.74 billion in immediate relief to New York State, which will face growing costs due to the virus and a likely economic downturn until the end of the public health emergency. 
• Increase in Medicaid Allotments for Territories – This section provides an increase to the territories’ Medicaid allotments for 2020 and 2021. It will ensure that territories that receive an FMAP increase under the previous section will have the necessary additional federal funds for their Medicaid programs.

NUTRITION

• SNAP Flexibility for Low-Income Jobless Workers – Suspends work and work training requirements for the Supplemental Nutrition Program (SNAP) during this crisis. Allows states to request special waivers to provide temporary, emergency SNAP benefits to existing SNAP households up to the maximum monthly allotment and provides more flexibility for States in managing SNAP caseloads.
• The Special Supplemental Nutrition Program for Women Infants and Children (WIC) – Provides $500 million to provide access to nutritious foods to low-income pregnant women or mothers with young children who lose their jobs or are laid off due to the COVID-19 emergency. Provides waivers to allow participants to be certified for WIC without being physically present at the WIC clinic, and to waive administrative requirements that are barriers to serving WIC participants during the coronavirus outbreak.
• The Emergency Food Assistance Program (TEFAP) – Provides $400 million to assist local food banks to meet increased demand for low-income Americans during the emergency. Of the total, $300 million is for the purchase of nutritious foods and $100 million is to support the storage and distribution of the foods.
• Nutrition Assistance for U.S. Territories – $100 million for USDA to provide nutrition assistance grants to Puerto Rico, American Samoa, and the Commonwealth of the Northern Mariana Islands in response to the COVID-19 public health emergency.
•  School Meals – The legislation includes a general provision that allows the Department of Agriculture to approve state plans to provide emergency Electronic Benefit Transfer (EBT) food assistance to households with children who would otherwise receive free or reduced-price meals if not for their schools being closed due to the COVID-19 emergency. In order to be eligible, the child’s school must be closed for no less than 5 consecutive days.
• Senior Nutrition Program – Includes $250 million for the Senior Nutrition program in the to provide approximately 25 million additional home-delivered and pre-packaged meals to low-income seniors who depend on the Senior Nutrition programs in their communities. This funding will provide meals to low-income seniors: who are home-bound; who have disabilities; who have multiple chronic illnesses; as well as caregivers for seniors who are home-bound.

EMERGENCY UNEMPLOYMENT INSURANCE

• Emergency Benefits – Provides $1 billion in 2020 for emergency grants to states for activities related to processing and paying unemployment insurance (UI) benefits, under certain conditions. 1) The first $500 million would be used to provide immediate additional funding to all states for staffing, technology, systems, and other administrative costs. The funding would be distributed in the same proportions as regular UI administrative funding provided through annual appropriations. 2) The other $500 million would be reserved for emergency grants to states which experienced at least a 10 percent increase in unemployment. Grants would allow states to take steps to temporarily ease eligibility requirements that are limiting access to UI during the COVID-19 outbreak, like work search requirements, required waiting periods, and requirements to increase employer UI taxes if they have high layoff rates. For states that experience an increase of 10 percent or more in their unemployment rate (over the previous year), the Act provides 100 percent federal funding for Extended Benefits, which normally require 50 percent of funding to come from states.
• Assistance for States –Provides states with access to interest-free loans to help pay regular UI benefits through December 31, 2020

PAID SICK DAYS AND EMERGENCY LEAVE – Includes $15 million for the IRS to implement refundable payroll tax credits for paid sick and paid family and medical leave.

For questions on the paid sick days and emergency leave provisions, the National Partnership for Women is fielding questions at info@paidsickdays.org

• Paid Sick Days – Includes $15 million for the Internal Revenue Service to implement tax credits for paid sick and paid family and medical leave. Requires employers with fewer than 500 employees and government employers to provide employees two weeks of paid sick leave, paid at the employee’s regular rate, to quarantine or seek a diagnosis or preventive care for coronavirus; or paid at two-thirds the employee’s regular rate to care for a family member for such purposes or to care for a child whose school has closed, or child care provider is unavailable, due to the coronavirus. Full-time employees are entitled to 2 weeks (80 hours) and part-time employees are entitled to the typical number of hours that they work in a typical two-week period.
• Emergency Family and Medical Leave Expansion Act – Provides 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 any of the following reasons: to adhere to a requirement or recommendation to quarantine due to exposure to or symptoms of coronavirus; to care for an at-risk family member who is adhering to a requirement or recommendation to quarantine due to exposure to or symptoms of coronavirus and; to care for a child of an employee if the child’s school or place of care has been closed, or the child-care provider is unavailable, due to a coronavirus. After the two weeks of paid leave, employees will receive a benefit from their employers that will be no less than two-thirds of the employee’s usual pay. This Act takes effect not later than 15 days after the date of bill’s enactment.