Energy and Commerce Committee Releases Draft COVID-19 Relief Bill

Legislation | February 10, 2021 | by Mollie Gurian

The House Energy and Commerce Committee released their draft reconciliation bill late on Tuesday evening and it contains a number of provisions that align with LeadingAge’s asks and provide much needed support for aging services providers. This Committee has broad jurisdiction. In this article we summarize the provisions most relevant to LeadingAge provider members related to vaccines, testing and PPE, workforce, and Medicaid.

Vaccines

The bill contains $7.5 billion dollars in funding for the Centers for Disease Control and Prevention (CDC) to prepare, promote, administer, monitor, and track COVID-19 vaccines. While all of the money is allocated to the CDC, the money can be utilized for a wide variety of purposes including distribution and administration of vaccines and ancillary supplies, support for state, local, tribal, and territorial public health departments, community vaccination centers, mobile vaccination units, information technology and data enhancements, facility enhancements, and public communications related to where, when, and how to get a vaccine. This means that the CDC is obtaining much needed additional funds to continue their implementation of a national vaccine strategy as outlined in the Biden National Strategy. The funds are flexible enough that the CDC can utilize them for national support or target them to states, localities, or providers to help with the vaccination effort.

Also critical to a comprehensive vaccine strategy is funding to continue to develop and purchase vaccines and therapeutics. The legislation addresses the supply chain for both vaccines and therapeutics by allocating $5.2 billion dollars to HHS to support research, development, manufacturing, production, and purchase of vaccines, therapeutics and ancillary medical products used for the treatment and prevention of COVID-19 and any variants as well as $500 million dollars for the FDA to be able to review new vaccines and therapeutics and track their use.

Finally, an additional $1 billion dollars is specifically set aside for CDC to strengthen vaccine confidence, further information and education with respect to authorized or licensed vaccines, and improve vaccination rates. This aligns with President Biden’s commitment to vaccine education and also with LeadingAge efforts to reduce hesitancy amongst employees of our members.

Testing and PPE

LeadingAge has advocated for a national testing strategy for nearly a year and we are pleased to see this legislation propose to fund that strategy. The bill allocates $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Specified activities include implementing a national strategy for testing, contact tracing, surveillance, and mitigation of COVID-19; guiding state and local public health departments in their work to implement the national strategy; support developing, manufacturing, procuring, distributing, and administering tests, personal protective equipment (PPE), and other supplies necessary for COVID-19 testing; establishing and expanding federal, state, or local testing and contact tracing capabilities, including investments in laboratory capacity, community-based testing sites, and mobile testing units; and sustaining our nation’s public health workforce.

The bill allocates $1.8 billion to HHS to support the purchase, procurement, or distribution of COVID-19 tests and testing supplies, PPE, and vaccines for staff and individuals in congregate settings including long term care. The Secretary can determine a mechanism by which to pay for all or part of the costs of administering or processing tests, so this is a point on which LeadingAge will continue to advocate for complete coverage of testing costs in long term care facilities. The same language is used as it relates to vaccines. HHS can also choose to use these funds to provide technical assistance or award grants to states and localities to support strategies to detect, diagnose, trace, or monitor COVID-19 in congregate settings including long term care.

There is also $1.75 billion dollars for CDC to improve their activities around sequencing and identifying new variants and $500 million dollars to expand and modernize data surveillance and analytics infrastructure.

Workforce

The bill invests in establishing, expanding, and sustaining a public health workforce. Some examples of how this $7.6 billion dollars will help LeadingAge member include but are not limited to: more lab personnel (which would lead to faster testing), contact tracers (which can help reduce community spread), social support specialists (who may be able to help with care coordination), and public health nurses (who could be deployed for a variety of activities like testing and vaccination). The bill also allocations $100 million dollars specifically for the Medical Reserve Corps, a network of volunteers that includes medical and public health professionals, who support emergency response efforts and community health activities. It is not yet clear what these Reserve Corps would be dispatched to do.

Medicaid

The bill makes major investments in the Medicaid program – this article is only going to cover the provisions that apply most directly to LeadingAge members. Most importantly for LeadingAge members, a longstanding ask to provide more support to Medicaid-financed home and community based services was included in the bill. States would get a 7.35% HCBS specific federal match (FMAP) bump for one year, with a “supplement not supplant” provision that makes the state use the additional dollars for HCBS, which can include (but is not limited to) rate increases, wait list reduction efforts, pay/paid leave for workers, and non-time limited retainer payments. While we will continue to push for the 10% bump that we asked for this population, we are pleased to see money directed to HCBS providers and parameters around what the money can be used for. We will also continue to push to be sure that this money is included in the Senate bill but its appearance in the House bill is a very positive sign.

The bill also has a specific FMAP increase for Medicaid coverage of COVID-19 vaccines and treatment without beneficiary cost sharing through one year after the end of the public health emergency and gives states the option to provide coverage to the uninsured for COVID-19 vaccines and treatment without cost sharing at 100% of FMAP.

The bill also contains an incentive for states that have not expanded their Medicaid programs to cover the population of adults up to 133% of federal poverty. If a non-expansion state chooses to expand after the presumed passage of this provision, that state would receive a 5% FMAP bump for its base FMAP for 2 years. So if you are in a non-expansion state, the federal government is offering to pay an additional 5% for two years for the populations already covered by the Medicaid program if your state chooses to expand (in addition to covering 90% of the FMAP for that expansion population). This matters to LeadingAge members in non-expansion states because if your state chooses to expand, your members could benefit from those extra FMAP dollars depending on how they are used.