What the American Rescue Plan means for healthcare
On Jan. 20, 2021, President Biden presented an impressive and aggressive plan to Congress: the American Rescue Plan. He urged Congress to approve $415 billion in immediate funding to contain the devastating COVID-19 pandemic, while simultaneously proposing additional spending to address our crushed economy. Altogether, it is a $1.9 trillion package, a figure under negotiation. The complete document may be found on the White House website; search for “president-biden-announces-american-rescue-plan.”
I will focus here on the healthcare aspects of the plan. Some of these health-focused solutions are necessarily tied to some, but not all the measures related to the economy.
The primary healthcare measures directly target the pandemic, while other measures are meant to shore up a hugely deficient Public Health System. All are needed to address concurrent COVID-19 tracking/testing and vaccination capabilities as well as future health-related issues. The following measures are emergency steps:
Develop a national vaccination program that covers all populations in our country, contains COVID-19, and enables the safe reopening of our education systems.
Make vaccines free of charge to all people, regardless of immigration status. (This is critical to ensure “herd immunity.”)
Make testing for the virus and its mutations widely available and support development of more accurate and rapid testing. Develop widespread tracking to impede the spread of the virus in communities. Invest in pandemic-related equipment, including personal protective equipment (PPE).
Here is how the President’s plan actually achieves the goals we so desperately need:
Proposes $50 billion to increase COVID-19 testing, which includes expansion of lab capacity, purchase and distribution of rapid testing kits, support for local governments in developing regular testing protocols so schools can safely reopen, and support for critical services so communities can function.
Provides $20 billion for a national vaccination program working with the states, localities, Tribes, and territories with the goal of vaccinating 100 million by the end of the President’s first 100 days in office. Mobile vaccination units would be deployed in hard-to-reach areas. All shall be eligible for vaccination regardless of their immigration status. COVID-19 can infect anyone, not just U.S. citizens.
Includes $10 billion to expand the domestic production of pandemic supplies.
Includes $30 billion for the Disaster Relief Fund to reimburse at 100% state, local, and Tribal governments for their disbursement of critical emergency supplies and resources during the pandemic.
Ensures that medical supplies as well as vaccines are distributed equitably and expands important healthcare services to underserved communities and Tribal lands.
Subsidizes insurance premiums for the continuation of healthcare coverage through COBRA through the end of September, giving access to healthcare for those who had coverage through their employers and lost their jobs.
Expands and increases the value of the Premium Tax Credit to lower or eliminate health insurance premiums for individual policies (e.g., on the ACA marketplace exchanges) and ensure that enrollees will pay no more that 8.5% of their income for coverage.
Covers all expenses for Medicaid enrollees to receive COVID-19 related services at 100% so that states would not be responsible for this additional cost.
Proposes $20 billion to improve and provide excellent care for the nation’s veterans, who have experienced greater needs for health-related services since the pandemic.
Provides $4 billion for Substance Abuse and Mental Health Services (SAMHSA) and the Health Resources and Services Administration (HRSA) because of the critical state of mental health for many Americans secondary to the impacts of COVID-19, as well as the enormous financial loss so many have experienced.
Includes $800 million in supplemental funding for key federal programs that protect survivors of domestic violence and sexual assault, which has become a “shadow pandemic” of COVID-19. Many women and girls who are largely confined to their home with their abuser face economic insecurity that makes escape more difficult.
President Biden’s plan addresses the needs of our public health system in significant other ways. It calls for mobilizing a public health jobs program to support COVID-19 response, investing in an additional 100,000 public health workers. This would nearly triple the country’s community health roles. These individuals would work in their local communities to do vaccine outreach and contact tracing in the near term, and to transition into community health roles, building our long-term public health capacity that will help improve quality of care and reduce hospitalization for low-income and underserved communities.
Underserved populations will be served by expanding Community Health Centers and investing in health services on Tribal lands. Funding will go toward the expansion of COVID treatment and care, as well as providing vaccinations to these populations.
All these measures and others that deal more directly with jobs and the economy will jump-start the recovery for our citizens and the economy. Delay in implementing these interventions can have dire consequences for the health of the nation. The President is exhorting Congress to act immediately on these proposals so the COVID-19 virus can be contained, benefiting all front-line workers and helping preserve families and communities.
What can you do to improve the chances that the COVID-19 crisis will be successfully managed? Here are some steps you can take: Contact your Congressmen, asking them to work cooperatively with the administration and support the American Rescue Plan. Their Capitol phone numbers are as follows: Rep Joyce: (202) 225-2431; Sen. Casey: (202) 224-6324; and Sen. Toomey: (202) 224-4254. Your own cooperation is also needed to defeat the virus: Get vaccinated as soon as you are able and continue to practice safety protocols of mask wearing, hand washing, and social distancing even after receiving a vaccine. These measures are key to protecting not just yourself, but others from the deadly Coronavirus.
Mary Frances Colvin is a retired Center for Medicare and Medicaid Services (CMS) nurse consultant and a member of Gettysburg Democracy for America’s Healthcare Task Force.