President Signs $2.3 Trillion Stimulus CARES Act
President Donald Trump signed a $2 trillion bipartisan stimulus package Friday that is intended to address the threat of economic disaster posed by the coronavirus pandemic.
The largest stimulus in U.S. history stimulus package aimed at resuscitating the economy following several weeks of severe, acute economic downturn. Senate and House passed the bill unanimously after a week. The following are the healthcare related provisions:
Hospitals will receive the $100 billion in federal assistance they initially requested be in the FFCRA along with a 20 percent bump in Medicare payments for treating COVID-19 patients. Experts expect rural hospitals to be hit especially hard during this pandemic, since they already operate on thin margins with limited staff.
Unlike the providers, insurers were not so lucky. Carriers requested an emergency fund to offset losses from the pandemic, including premium subsidies to help fund temporary COBRA coverage, but received nothing.
The bill expands coverage beyond what was in last week’s Families First bill by requiring health insurers to pay for coronavirus testing beyond those that are FDA-approved to include those provided by labs, state-developed tests, and any other tests approved by HHS.
Accessibility for telehealth is also expanded. High deductible health plans with HSAs may now allow pre-deductible coverage for telehealth and other remote services, as well as allowing the use of HSAs for the purchase of over-the-counter medications without a prescription. In the past, the HSA Deductibel would have to first be met.
OTC items bought with pre-tax funds
After the Affordable Care Act, over-the-counter (OTC) drugs and medicines required a prescription in order to be eligible for reimbursement from an HSA, FSA or HRA. The CARES Act would allow individuals enrolled in these pre-tax accounts to pay for OTC drugs and medicines without a prescription. This action helps to reduce additional strain from an already overwhelmed healthcare system. This is a permanent chang
Very limited action was also taken to address surprise medical bills. Under the CARES Act, all health insurance plans would reimburse a COVID-19 test provider at the in-network rate put in place prior to the breakout. If the provider is out of network, the health plan is to fully reimburse the provider based on the provider’s own “cash price” which must be made publically available while the public health emergency is still declared. Providers that do not post their test price publically could be fined up to $300 a day. States like NYS in 2015 and NJ in 2018 have already passed Surprise Medical Bill Laws.
Will the Empire State see relief with the passage of the CARES Act? Governor Cuomo is not so sure, claiming that the $3.8 billion New York will receive is “a drop in the bucket as to need,” and that a previous House bill would have given his state $17 billion. Cuomo’s budget office predicted on Tuesday that state revenue losses could be as high as $15 billion.
Additionally, NYS Department of Labor received over one million calls from recently unemployed individuals in a single week, while the country as a whole reported 3.3 million jobs lost. The governor had already implemented several executive orders and moratoriums to provide relief for New Yorkers, including a 90-day pause on evictions as well as a halt on both medical debt and student loan debt collection. This week, the governor announced that utility companies will postpone rate increases that were set to go into effect on April 1.
The bill also provides $150 billion for state and local governments, as states quickly burn through their own funding. Several states anticipate they will face multibillion-dollar budget shortfalls. New York’s budget office, for example, anticipates state revenue losses could be as high as $15 billion. The massive stimulus package also includes:
- $200 million to be invested in telemedicine
- $30 Billion for education funding
- $25 Billion for public transit
- $17 Billion for small businesses
- $10.5 billion for the Pentagon, including $1.5 billion to deploy the National Guard
- $10 billion Treasury loan for the Postal Service
The 800-page Act includes many provisions to help small and medium-sized businesses (SMBs). It will provide $350 billion worth of loans to SMBs. Note:
Small business interruption loans
This is in addition to the Small Business Administration (SBA) Economic Injury Disaster Loan program, which provides loans up to $2 million and is available to SMBs in all 50 states.
Small businesses, non-profit organizations, sole proprietorships, and self-employed individuals with 500 or fewer employees per location are eligible for loans up to $10 million. The maximum interest rate is 4%.
The loan can be used to provide:
- Mortgage or rent payments
- Utility payments
- Healthcare premiums
- Other debt obligations
Any portion of the loan used for payroll and existing debt obligations will be eligible for loan forgiveness for an 8-week period from the beginning of the loan, given they can maintain the equivalent number of full-time employees through June.
Organizations that have already laid off workers due to the pandemic will still be eligible for the loans and loan forgiveness if they rehire their staff members.
Portions of the loan used for payroll issued to workers who earn over $100,000 will not be forgiven.
The stimulus legislation states portions of the loans used for covered expenses will convert to grants, but interest will still have to be paid.
Loan forgiveness is reduced proportionately to any reduction in workforce or wages compared to the prior year.
Businesses that receive funding under the “Paycheck Protection Program” are not eligible for the SBA EIDL loans.
- Any portion of the loan used for payroll and existing debt obligations will be eligible for loan forgiveness for an 8-week period.
- The Act also provides a refundable payroll tax credit equal to 50% of “qualified wages.
- Qualified individuals will receive up to $1,200 per person (or $2,400 for married filing jointly) with an additional $500 per child. The benefit decreases by $5 for every $100 in income over $75,000 and will not be paid to single taxpayers who make $99,000 (or $198,000 for married filing jointly).
- Federal Income Tax Returns normally due on April 15 will not be due until July 15, 2020.
- The Act extends unemployment benefits from 26 weeks to 39 weeks. The benefit amount is calculated under state law, plus $600 in federal funding per week up to 4 months. It will also waive the one-week waiting period.
- It also provides unemployment benefits for self-employed workers and contractors.
The legislation is surprisingly vague on exactly how the money will be distributed, although most of those who have been working to shape it assume that HHS Secretary Alex Azar will likely have a major role to play.
The information provided on this website is intended for informational purposes only. As more details emerge, we will continue to update this article. Millennium Medical Solutions Corp. does not offer legal or medical guidance. Those with legal or medical questions should seek appropriate assistance from a licensed professional. Stay up to date by signing up for Newsletter and Coronavirus Dashboard below.