The full Senate began debate of the American Rescue Plan Act of 2021 (H.R. 1319), a $1.9 trillion budget reconciliation package to respond to COVID-19 and provide economic stimulus, on March 4 [see Washington Highlights, Feb. 26]. The House passed the legislation by a vote of 219-212 on Feb. 27 following a series of markups within committees of jurisdiction [see Washington Highlights, Feb. 12].
The Senate is considering a substitute amendment to the House-passed legislation, which includes modifications to several provisions that would impact the academic medicine community and its patients and communities. The Senate package builds on the House’s efforts to help workers who lost their jobs retain their health insurance by increasing the premium assistance for COBRA continuation coverage for eligible individuals and families from 85% to 100% through Sept. 31, 2021. Despite continued stakeholder engagement and outreach, the legislation does not address the Medicare sequester moratorium that expires on March 31, nor does it include additional resources for the Provider Relief Fund. It does however, include $8.5 billion for rural providers.
The Senate proposal maintains $47.8 billion to increase COVID-19 testing capacity and contact tracing, and includes text specifying that investments in resources such as academic research labs could be used expand capacity. The Senate package also maintains $6.05 billion for “research, development, manufacturing, production, and the purchase of vaccines, therapeutics, and ancillary medical products and supplies to prevent, prepare, or respond” to SARS-CoV-2 or COVID-19, and $1.75 billion for the CDC to increase genome sequencing of SARS-CoV-2 for variant surveillance.
The Senate proposal also maintains the House-passed funding levels of $7.5 billion for the Centers for Disease Control and Prevention (CDC) and $500 million for the Food and Drug Administration (FDA) for COVID-19 vaccine activities including promotion and distribution, $1 billion to the CDC for public campaigns on vaccine confidence, and $7.7 billion in awards under the Department of Health and Human Services to state, local, and territorial health departments to establish, expand, and sustain the public health workforce. The bill also maintains $350 billion for state, local, territorial, and Tribal funding through proposed State and Local Fiscal Recovery Funds to support local economies.
Like the House version, the Senate bill also would provide $800 million for the National Health Service Corps loan repayment and scholarships program, $140 million for provider well-being initiatives, and nearly $40 billion for institutions of higher education. The proposal also includes a new provision that would prevent any type of student loan forgiveness over the next five years from resulting in a tax bill for the borrower.
Following House passage, AAMC President and CEO David J. Skorton, MD, issued a press release thanking the House for its “swift efforts … in advancing important priorities to support the nation’s continuing COVID-19 response” including funding for state and local jurisdictions, vaccine development and distributions, and SARS-CoV-2 testing and sequencing as well as expanding access to affordable health coverage and support for providers and loan repayment for medical students. The statement also urged Congress to provide additional financial relief for federal research agencies as well as teaching hospitals and faculty physicians to support recovery of the research and patient care missions of academic medicine.
The Senate began a series of votes on additional amendments to the legislation on March 5 and is expected to vote on the measure on March 6, with only a simple majority required for passage. The Senate-passed bill will need to be agreed to in the House before it can be signed into law.