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Wednesday, April 1, 2020

If you are a person impacted by the novel coronavirus (COVID-19), are living with cancer, or are immunocompromised, one important way to maintain some sense of control in what might be an anxiety-provoking time is to understand what is being done from a policy perspective to help respond to the pandemic, and how these changes have the potential to actually impact you and your community.

Background

On March 13, 2020, President Trump declared a state of emergency which will allow for faster responses and relief efforts across the United States, as well as provide additional resources for testing and treatment. As a result, the Federal Emergency Management Agency (FEMA) has been leading the response in states heavily impacted by COVID-19 to help build mobile response centers and assist with public safety.

Congress has undertaken legislative action to respond to the crisis with three large emergency coronavirus stimulus packages. These bills are aimed at funding research, treatment, and vaccine development, increasing access to certain health care provisions, and lessening the economic suffering for individuals and business, as a result of the coronavirus pandemic.

First Stimulus Package

First Stimulus Package

Bill: The Coronavirus Preparedness and Response Supplemental Appropriations Act
Passed: March 6, 2020
Focus: Research and Vaccine Development, Small Business Relief, and Telehealth Flexibility
Funding: $8.3 Billion

COVID-19 Testing

The Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 was signed into law to help fund research and vaccine development. This $8.3 billion aid package provided emergency funding for federal agencies to respond to the coronavirus outbreak, including $4 billion to make more coronavirus tests available.

Loans to Small Businesses 

The bill also includes $1 billion in loan subsidies to be made available to help small businesses who have been impacted by financial losses as a result of the COVID-19 crisis. This funding could enable the Small Business Administration (SBA) to provide an estimated $7 billion in loans to small businesses. Learn more at SBA’s Small Business Guidance & Loan Resources webpage.

Telehealth Flexibility

Additionally, the bill includes a waiver removing restrictions on Medicare providers to allow them to offer telehealth services to Medicare beneficiaries regardless of whether they are in a rural community or not. The provision allows beneficiaries who are covered by Medicare to receive telehealth services from home, reducing the potential risk of COVID-19 exposure associated with visits to medical facilities.

Second Stimulus Package

Bill: Families First Coronavirus Response Act
Passed: March 18, 2020
Focus: COVID-19 Testing Access, Emergency Sick and Family Leave, Unemployment Insurance, and Nutrition Assistance
Funding: $104 Billion, according to Joint Committee on Taxation estimates

The Families First Coronavirus Response Act was signed into law to provide rapid assistance on many fronts including:

Free COVID-19 Testing

The bill allows for free COVID-19 testing, including emergency room visits and doctor’s fees, for all patients, regardless of insurance type or status. Contact your health care insurer directly with any questions regarding this provision. The bill also provides $1 billion to the National Disaster Medical System to reimburse providers for the costs of COVID-19 testing for uninsured individuals.

Emergency Paid Family and Medical Leave

The bill provides funding for paid time off to allow some symptomatic or exposed workers, or parents of children with school closures, to stay home through Family and Medical Leave Act (FMLA) leave. Under this provision, employers with fewer than 500 employees and government employers will have to provide eligible full-time employees up to 10 days/80 hours of paid sick leave, while part time employees are eligible for leave based on the number of hours typically worked in a two-week period. Employees who are unable to work (or telework) are eligible for this paid sick leave if they meet any one of the following six eligibility categories:

  1. Are subject to a Federal, State, or local quarantine or isolation order related to COVID-19,
  2. Have been advised by a health care provider to self-quarantine due to concerns related to COVID-19,
  3. Are experiencing symptoms of COVID-19 and seeking a medical diagnosis,
  4. Are caring for an individual who is subject to an isolation order or is a quarantined employee,
  5. Are caring for a child if the school or childcare provider has been closed, due to COVID-19 precautions, or
  6. Are experiencing any other substantially similar condition as specified by the Secretary of Health and Human Services.

Paid sick leave is calculated based on an employee’s regular compensation, up to $511 per day (up to a total of $5,100) for employees who fall into the first three eligibility categories (1-3) listed above. For employees who fall into categories 4-6, paid leave is no less than two-thirds of their regular compensation, up to $200 per day (up to a total of $2,000). Employers are reimbursed through a payroll tax credit, which applies to both for-profit and non-profit employers.

Additionally, employees unable to work because they are caring for a child due to COVID-19 related school or childcare closures, can receive family leave pay for a month (up to three months) at a rate not less than two-thirds of their usual pay, capped at $200 per day (up to a total of $10,000). This emergency leave will take effect after 10 days of unpaid leave; however, an employee can utilize vacation, sick, or personal leave during these 10 days. An employee must have worked for at least 30 calendar days for the employer to be eligible for benefits under this provision.

Health care providers or emergency responders can elect out of providing paid sick leave to these employees. The Department of Labor can also issue exemptions for employers of fewer than 50 employees. For more information about whether this provision applies to you, please visit the Department of Labor.

The bill directs that the provisions of the emergency paid sick leave and emergency paid family leave take effect no later April 2 through December 31, 2020.

Expanded Unemployment Insurance

The bill directs $2 billion to state unemployment insurance programs that see spikes in unemployment enrollment due to COVID-19. Certain eligibility requirements are waived under this provision for those who have lost their jobs due to the spread of the virus, including work search requirements and the waiting week. View your state unemployment insurance program to learn more.

Food Assistance

The bill provides emergency funding to ensure the nutrition assistance programs have adequate resources to help those impacted by the COVID-19 public health emergency, including the Supplemental Nutrition Program for Women Infants and Children (WIC), senior nutrition programs, and food banks. The bill also suspends the work and work training requirements for SNAP (formerly known as the food stamp program) during this crisis. For more information about these nutrition assistance programs, please visit the U.S. Department of Agriculture website.

Third Stimulus Package

Bill: The Coronavirus Aid, Relief, and Economic Security Act (CARES Act)
Passed: March 27
Focus: Broad Economic Stimulus
Funding: $2 Trillion

A third stimulus package focused on broad economic stabilization, The Coronavirus Aid, Relief, and Economic Security Act, was signed into law on March 27. This bill will provide assistance to individuals, businesses, and infrastructure, including:

Direct Payments
The bill provides a one-time, direct deposit payment to individuals and families, who are not a dependent of another taxpayer and have a valid social security number, based on the income levels below:

  • $1,200 for individuals ($75,000 income cap)
  • $2,400 for couples ($150,000 joint income cap)
  • $500 for each qualifying child 16 years old or younger

For individuals and couples whose income is more than the caps noted above, payments are adjusted by 5% of income, phasing out at $99,000 for individuals and $198,000 for couples (without children). The payments will be based on an individual's 2019 tax return, if they already filed it, or their 2018 return. People who receive Social Security retirement and disability payments each month are eligible to receive the payment. Learn more on the IRS' Economic impact payments: What you need to know webpage.

The IRS announced of March 30 that distribution of payments will begin in the next three weeks and will be distributed automatically, with no action required for most people. However, they indicate that some seniors and others who typically do not file returns will need to submit a simple tax return to receive the stimulus payment. This information will soon be found on their website at IRS.gov/coronavirus.

Expanded Unemployment Insurance
The CARES Act creates a temporary Pandemic Unemployment Assistance program to provide payment to those not traditionally eligible for unemployment benefits (self-employed, independent contractors, and gig economy workers).

The bill further expands unemployment insurance to recipients of unemployment insurance and individuals in the Pandemic Unemployment Assistance program by:

  • Waives the 7-day waiting period for benefits.
  • Raises the maximum benefit by $600 per week, for up to four months.
  • Provides an additional 13 weeks of unemployment benefits of federally funded unemployment insurance benefits.

For more information about filing for unemployment insurance, visit the Department of Labor website to learn more.

Payroll Taxes
The bill includes a provision that enables individuals to defer payment of 2020 taxes until 2021 or 2022.

Student Loans
The bill requires the Department of Education to suspend monthly payments on all federally held student loans, without interest, through September 30, 2020. Borrowers with those loans would not have their credit dinged for the suspended payments and the postponement would not interrupt their progress toward any federal loan forgiveness programs. The suspension of payments does not apply to private loans, federally guaranteed loans held by private lenders, or federal Perkins loans.

The bill also creates a provision that enables employers to provide a student loan repayment benefit to employees on a tax-free basis. Under the provision, an employer may contribute up to $5,250 annually toward an employee’s student loans, and other educational assistance (e.g., tuition, fees, books), and such payment would be excluded from the employee’s income.

Emergency Relief
The bill includes over $330 billion in emergency relief funding, including $100 billion for hospital, public and not-for-profit entities, and Medicare and Medicaid providers to cover costs related to crisis.

The bill also provides emergency assistance to:

  • $25 billion for the Emergency Food Assistance Program, which includes:
    • Supplemental Nutrition Assistance Program (SNAP) – The bill includes $15.5 billion in additional funding for SNAP to ensure all Americans, including seniors and children receive the food they need.
    • Child Nutrition Programs – The bill includes $8.8 billion in additional funding for Child Nutrition Programs in order to ensure children receive meals while school is not in session.
    • $450 million for food banks, the Emergency Food Assistance Program (TEFAP).
  • $30 billion for the Disaster Relief Fund to provide financial assistance to state, local, tribal, and territorial governments, as well as private nonprofits providing critical and essential services. 
  • $7 billion for affordable housing and homelessness relief
  • $200 million for Centers for Medicare & Medicaid Services (CMS) to assist nursing homes
  • $425 million to increase access to mental health services in communities
  • $1 billion for the Defense Production Act to bolster domestic supply chains, enabling industry to quickly ramp up production of personal protective equipment, ventilators, and other urgently needed medical supplies.
  • $16 billion to replenish the Strategic National Stockpile supplies of pharmaceuticals, personal protective equipment, and other medical supplies, which are distributed to state and local health agencies, hospitals and other healthcare entities facing shortages during emergencies.
  • $4.3 billion to support federal, state, and local public health agencies to prevent, prepare for, and respond to the coronavirus, including for the purchase of personal protective equipment.
  • $45 billion for FEMA’s Disaster Relief Fund
  • $30.75 billion for local school systems and higher education institutions
  • $25 billion for transit systems
  • $10 billion for airports

While the CARES Act didn't include COBRA subsidies to help employees continue their job-based coverage after being laid off due to COVID-19, under current law individuals who lose their jobs are able to sign up for a health plan on the state marketplaces or could qualify for Medicaid. Learn more on Healthcare.gov.

What Happens Next?

Additional legislative action is expected be taken to further address the challenges posed by COVID-19, and CSC is actively working with policymakers on the next iteration to continue to advocate for the health and well-being of people impacted by cancer.

The Cancer Support Community will continue to update this information and reach out to you with breaking news. In the meantime, please visit our website, cancersupportcommunity.org/coronavirus, on what people impacted by cancer need to know about COVID-19. Sign up for our Grassroots Network to ensure that you receive all policy updates on issues that will impact people with cancer.

Editor’s Note: This blog has been updated on April 1, 2020​

Please note that Coronavirus policy updates are quickly evolving. We are providing this content for informational purposes only and updating it as quickly as possible. If you have questions or concerns, please contact action@cancersupportcommunity.org.

Category: Cancer Advocacy

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