On March 3, the United States Senate unveiled updated text for a $1.9 trillion COVID relief package that includes an additional $8.5 billion to support rural health care providers.
The $8.5 billion comes on top of $178 billion being authorized for providers in previous COVID relief packages, the vast majority of which has already gone out. The Wisconsin Hospital Association (WHA) estimates its members have received upwards of $1.1 billion from the previous funding, while experiencing at least $2.5 billion in losses as a result of the pandemic. Losses were mainly a result of being asked to shut down elective procedures for a number of weeks early on in the pandemic due to a lack of personal protective equipment (PPE) and the need to preserve hospital beds for COVID patients. However, providers have reported that service levels dipped again during the surge of late fall 2020, and have remained down since then as some patients are still not seeking care they would have prior to the pandemic.
WHA sent out a Hospitals Education and Advisory Team (HEAT) alert earlier this week urging hospital leaders to contact Capitol Hill to share their stories and express support for additional relief. WHA has continued to push for additional provider relief, but up until now, prior versions of the current COVID package had not included it.
In addition to this relief for rural providers, the COVID legislation also includes a number of other positive items to increase health care coverage and aid COVID response efforts, including:
- ACA Marketplace plan and COBRA subsidies, including:
- Allowing Individuals between 100-150% of the federal poverty level (FPL) to pay no premiums for a marketplace plan and allowing some over 400% FPL to begin qualifying for subsidies
- Subsidizing 100% of the cost of COBRA plans to allow individuals and families to remain on their previous employer plans after losing their job
- $80 billion to support vaccine distribution, continued testing and contact tracing efforts, therapeutics, and medical supplies
- $3.5 billion in mental health and substance abuse block grants
- $450 million to help skilled nursing facilities (SNFs) avoid and mitigate COVID outbreaks
- $500 million in grants for rural hospitals and other entities to assist with vaccine distribution and telehealth
- Allowing 501(c)(3) organizations (including hospitals) to be eligible for Paycheck Protection Program (PPP) loans if their physical location has fewer than 500 employees
Despite these beneficial items, legislators have also received pushback for including a number of earmarks in this COVID package. WHA has been working to remove one that would unfairly game the Medicare wage index to benefit only three states on the east coast. This earmark would bring back the imputed rural floor that the Centers for Medicaid & Medicare (CMS) had allowed to expire in 2018, noting that it unfairly increased Medicare payments for the three states who had it. WHA has for years been trying to untangle aspects of the wage index (such as the Bay State Boondoggle
) that unfairly warp Medicare payments to benefit some states at the expense of others.
The package is expected to be passed later this week on a party-line vote in the Senate under a budget process known as reconciliation, which will allow passage on a simple majority vote. It would then be sent back to the U.S. House for final approval. Democrats have been eyeing March 14 as the date to send a bill to President Biden’s desk as federal unemployment benefits expire on that date. Please contact WHA Vice President of Federal and State Relations Jon Hoelter