Democrats notched a $100 billion victory Tuesday after an agreement to replenish funding for small-business loans included additional money for medical providers and coronavirus testing, but some providers and lawmakers said more help is needed.
Hospitals and other medical providers said they welcomed the additional aid sought by Democrats, but a tug-of-war among provider groups will likely continue. The American Hospital Association recently requested that the Department of Health and Human Services prioritize hospitals in a separate $100 billion fund that Congress provided in a previous law.
The fourth economic aid bill addressing the coronavirus pandemic includes $75 billion for medical providers and $25 billion to increase testing capacity. The legislation passed the Senate by voice vote Tuesday afternoon and is expected to be considered by the House on Thursday.
The funding falls short of the $318 billion the American Medical Group Association requested in a letter Tuesday to help medical providers cover losses. A survey by the association found that 60 percent of independent doctor groups estimate they will deplete their financial reserves in two months, while one-third are providing uncompensated care for area hospitals.
The bill does not appear to include two provisions that rural and safety-net advocates were pushing: a clarification ensuring that public hospitals are eligible for the small-business loans and a reduction of a 10 percent interest rate in Medicare’s advance payment loan program.
The chances of including changes to the interest rate for Medicare’s advance payment loan program look promising in the next economic aid package. Sen. Jeanne Shaheen, D-N.H., said the administration agreed to support future efforts to modify the program’s interest rate and payback timeline after bipartisan groups of lawmakers called for changes.
“This program has been an important source of upfront revenue for Granite State providers to mitigate the economic shortfall they’re facing, so I’m glad this fix will provide some relief as we work through this crisis,” Shaheen said in a statement.
Providers — including the Federation of American Hospitals, which represents for-profit institutions — are lobbying for the change. Chip Kahn, president and CEO of the Federation of American Hospitals, called changes to the Medicare loan program “mission-critical.”
Sen. Joe Manchin III, D-W.V., expressed concern that rural providers would continue to be shortchanged since the bill lacks the provision allowing public hospitals to qualify for the small-business loans. “I will keep fighting to change the formula for distributing this emergency health care funding to ensure our rural health providers receive their fair share,” he said.
Members of the House Congressional Black Caucus raised another concern, saying the legislation needs stronger language on the collection of demographic data. Robin Kelly, D-Ill., who chairs the CBC Health Braintrust, said she and other members would meet with Centers for Medicare and Medicaid Services Administrator Seema Verma and leaders at the National Institutes of Health on the issue.
“This administration has proven time and time again that we cannot trust them, quite frankly,” she said. “Congress needs to ensure through law that this data is collected and properly analyzed.”
The new bill also would direct $11 billion to state, local and tribal governments to build capacity for testing and contact tracing, and support testing by employers. Of that, $2 billion would be distributed to every state according to the formula used in Public Health Emergency Preparedness grants, while another $4.3 billion would be allocated based on the number of cases per state.
The remaining $14 billion in testing funds would bolster the federal government’s response, with a number of agencies receiving specific allocations. The Centers for Disease Control and Prevention would get $1 billion for research and contact tracing, while the National Institutes of Health would win $1 billion to research and develop new testing technologies. The Biomedical Advanced Research and Development Authority would receive $1 billion to look into testing technologies and supplies.
The bill also sets aside $1 billion to cover the cost of testing for the uninsured, something that Health and Human Services Secretary Alex Azar has already promised providers the department would help cover under the existing $100 billion emergency fund included in the previous aid package.