American Rescue Plan of 2021 Brings Dollars to Vermont, Health Care

On March 11, President Biden signed into law the American Rescue Plan Act of 2021, which includes a number of provisions that affect physicians and other health care providers. It will also bring over $2 billion dollars into Vermont to support municipalities, infrastructure, individuals, the education system, childcare, public transit and more. Some of the major sections that impact health care are summarized below. VMS will be monitoring the work by the legislature and Scott Administration to allocate this funding and ensure physicians receive the financial support needed to weather the pandemic.

PUBLIC HEALTH & WORKFORCE FUNDING

  • $7.5 billion directed to the Centers for Disease Control and Prevention to plan, prepare for, promote, distribute, administer, monitor and track COVID-19 vaccines
  • $47.8 billion to continue implementation of an evidence-based national COVID-19 testing strategy
  • $7.66 billion to state, local and territorial public health departments to hire staff and procure equipment, technology and other supplies to support public health efforts
  • $100 million for the Medical Reserve Corps
  • $800 million for the National Health Service Corps
  • $200 million for the Nurse Corps
  • $330 million for teaching health centers that operate graduate medical education.

PROVIDER FINANCIAL RELIEF

  • $8.5 billion to established Provider Relief Fund for eligible rural providers for healthcare-related expenses and lost revenues attributable to COVID-19 not reimbursed (or obligated to be reimbursed) by other sources
    • Rural providers and suppliers seeking the ARP funds must submit an application to HHS
    • (This is in addition to about $25 billion that remains to be allocated out of the Provider Relief Fund (PRF) established by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed in March 2020)
  • $500 million to the Department of Agriculture to award grants to eligible entities, including certain rural providers, based on needs related to the COVID-19 pandemic
  • An additional $7.25 billion allocated to the Paycheck Protection Program

FUNDING FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS

  • $3 billion for block grants to state and local government entities to address mental health and substance use disorders

FUNDING FOR STATE, LOCAL AND TRIBAL GOVERNMENTS

  • $350 billion to states, localities and tribes ($220 billion to states, $130 billion to local governments) to be used until December 31, 2024. Can be used for public health efforts responding to the COVID-19 pandemic, and for efforts to address the pandemic’s economic impact, including assistance to households, small businesses and nonprofits. It can also be used to make investments in public health infrastructure and to respond to decreases in revenue due to the COVID-19 pandemic

Medicaid

  • Medicaid programs to cover without cost sharing the treatment or prevention of COVID-19 for one year after the end of the public health emergency
  • Raises the FMAP to 100% for payments to states for administering vaccines for the same period
  • Incentives for states that have not expanded Medicaid coverage under the ACA
  • Gives states the option to extend health coverage for women enrolled in Medicaid or CHIP for up to 12 months after the birth of a child (vs current 60 days of coverage)
  • Increases the FMAP by 10 percentage points for state home and community-based services

Health Insurance

  • Subsidizes 100% of the COBRA premiums for eligible individuals
  • Expands availability of health insurance marketplace advanced premium tax credits to eligible individuals whose income is above 400% of the FPL, based on a sliding scale

Issues not addressed in the Rescue Plan

  • Changes to scheduled terms for loan repayment or forgiveness for Medicare Accelerated and Advance Payments made to providers and suppliers
  • Changes to Medicare coverage of telehealth
  • 2% across the board reductions in Medicare payments to providers from 2013 through 2029 due to the Budget Control Act of 2011 (scheduled to go into effect April 1, 2021)

For more information, see the summaries available from:

The Senate Democrats

The National Law Review

The American Hospital Association