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What's In The $2 Trillion Bill For Health Care?

Mar 27, 2020
Originally published on March 27, 2020 7:35 pm

Most of the gargantuan sum of money in the coronavirus bill Congress just passed is dealing with the economic crisis, not the public health one.

"Most of the bill is on emergency relief to people and unemployment insurance," says Loren Adler, associate director of USC-Brookings Schaeffer Initiative for Health Policy. "The health care provisions are, in some sense, secondary."

For health, the biggest ticket item is $100 billion for hospitals and health care providers. Professor Lindsay Wiley, of the American University Washington College of Law describes it as a kind of "pre-disaster bail out" for hospitals, and notes that the details of where it will be distributed and in what amounts is not laid out. "It's likely to be hotly contested," she says.

Adler notes this money isn't just for direct care for coronavirus patients, but also for indirect losses.

"We already have hospitals canceling tons of elective care and seeing pretty big revenue hits because of that," he says. "Obviously, we desperately need hospitals to stay open and be functioning right now."

There are other provisions that help hospitals, like bonuses for coronavirus patient care, a bump in Medicare payments, no-interest loans and more.

There is nearly a billion dollars for research and development for vaccines and therapeutics.

And there's $16 billion for the Strategic National Stockpile. The lack of sufficient funding for this stockpile has been made clear in the past few months and weeks, with stories of U.S. health care workers begging for personal protective equipment like masks and gowns and hand sanitizer.

"That money is an assurance for companies that are investing in manufacturing — whether that be [personal protective equipment] or vaccines — that government will be a purchaser at the end," says Dara Lieberman with the research and advocacy group Trust for America's Health. (As NPR has reported, in the past companies have ramped up production only to see demand dry up when a crisis passes.)

Lieberman also notes $500 million allocated for public health modernization — another place a chronic lack of investment is now showing. "We know a lot of health departments are still dependent upon archaic methods of tracking diseases, whether that's phone or fax or paper," she says.

Wiley says she's "pretty impressed with the attention to indirect impacts" addressed in the bill, noting grants for suicide prevention and for substance use disorder treatment, which is suddenly having to shift to telemedicine.

Jen Kates of the Kaiser Family Foundation says one thing that's missing is consideration of all the treatment costs that patients might face as more and more Americans get the coronavirus. Patients could still be stuck with paying their full high deductibles or even face surprise bills after being hospitalized.

Nothing Congress has passed so far has addressed this issue, so people who are already dealing with unemployment, loneliness and fear, may still have to worry about getting buried in medical bills, too.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

AILSA CHANG, HOST:

The $2 trillion coronavirus relief bill contains a lot of help for a lot of industries, but what's in there for health care? NPR health policy reporter Selena Simmons-Duffin gives us the highlights.

SELENA SIMMONS-DUFFIN, BYLINE: Most of that gargantuan sum of money is dealing with the economic crisis here, not the public health one, going to things like emergency relief for various industries, unemployment insurance and the like. For health, the biggest-ticket item is $100 billion for hospitals and health care providers.

LINDSAY WILEY: Pre-disaster bailout is how I would describe what this bill is doing.

SIMMONS-DUFFIN: That's Professor Lindsay Wiley of the American University Washington College of Law. She knows there's nothing in this bill that explains how that money should get distributed to different places in the U.S. and that it's probably going to be hotly contested. Loren Adler of the USC-Brookings Schaeffer Initiative for Health Policy notes this money for providers isn't just for direct care for coronavirus patients but also for indirect losses.

LOREN ADLER: We already have hospitals canceling tons of elective care, seeing pretty big revenue hits because of that. And, obviously, we pretty desperately need hospitals to stay open and be functioning right now.

SIMMONS-DUFFIN: There are other provisions that help hospitals, like bonuses for coronavirus patient care, a bump in Medicare payments, no-interest loans and more. There is nearly a billion dollars for research and development for vaccines and therapeutics and $16 billion for the Strategic National Stockpile. The lack of sufficient funding for the stockpile has been made clear in the past few months and weeks, with stories of U.S. health care workers begging for personal protective equipment like masks and gowns and hand sanitizer. Dara Lieberman is with the research and advocacy group Trust for America's Health.

DARA LIEBERMAN: That money is an assurance for companies that are investing in manufacturing, whether that be PPE or vaccines, that government will be a purchaser at the end.

SIMMONS-DUFFIN: She also notes $500 million for public health modernization, another place the chronic lack of investment is now showing.

LIEBERMAN: So we know a lot of health departments are still dependent upon archaic methods of tracking diseases, whether that's phone or fax or paper.

SIMMONS-DUFFIN: She says investing in these modern systems is really an investment for next time we're dealing with an epidemic like this. Beyond hospitals and public health...

WILEY: I'm pretty impressed with the attention to indirect impacts.

SIMMONS-DUFFIN: Wiley cites as examples grants for suicide prevention and substance use disorder treatment, which is suddenly having to shift to telemedicine. One thing that's missing in here, says Jen Kates of the Kaiser Family Foundation - attention to all the costs that patients might face as more and more Americans get this virus. She says the cost of testing has been well-addressed, but...

JEN KATES: Beyond testing, there's treatment costs, you know, that people will be faced with. So that is a big issue.

SIMMONS-DUFFIN: Patients could still be stuck with paying their full high deductibles - thousands of dollars - or even face surprise bills after being hospitalized with coronavirus. Nothing Congress has passed so far has addressed this issue, so people who are already dealing with unemployment, loneliness, fear and the rest still have to worry about getting buried in medical bills, too.

Selena Simmons-Duffin, NPR News. Transcript provided by NPR, Copyright NPR.