Over four whirlwind weeks, Congress passed and President Donald J. Trump signed into law three pieces of legislation focused on combating coronavirus disease 2019 (COVID-19).
Following is a look at each law and what the AAP is asking for in future legislation. At press time, Congress had not yet introduced an anticipated fourth legislative package.
Importantly, while these laws contain vital federal response policies to coronavirus, how they are implemented will be key to their success. The Academy continues to weigh in and will keep members informed.
As the COVID-19 pandemic persists, the Academy will serve as the leading voice for children and pediatricians in the nation's capital, urging lawmakers to address the needs of children and families, medical professionals on the front lines and the larger health care community.
Coronavirus Preparedness and Response Supplemental Appropriations Act
Signed into law March 6
This law was the first major legislative effort in ramping up the federal government's response to the pandemic. The package included $8.3 billion in emergency funding to federal agencies to support key domestic programs. It also aimed to bolster vaccine and medical countermeasure development, global preparedness programs and response mechanisms, and international partnerships.
Families First Coronavirus Response Act
Signed into law March 18
This package of more than $100 billion included numerous provisions to aid families, including several the AAP advocated for. Of note, the law required health insurance to cover COVID-19 testing. It also waived the physical presence requirement for the Special Supplemental Nutrition Program for Women, Infants, and Children, allowing for remote certification and benefits issuance as well as deferment of other in-person requirements.
In addition, the law provided paid sick and family leave for certain employees to take care of themselves and loved ones during the pandemic. While it was a critical provision, the Academy said it did not go far enough because many workers were left out. The same week, the AAP endorsed the Providing Americans Insured Days of (PAID) Leave Act, which would immediately provide all workers with paid sick days and paid family and medical leave and expand access for future crises and life events.
Coronavirus Aid, Relief, and Economic Security (CARES) Act
Signed into law March 27
This more than $2 trillion stimulus package contained relief for pediatricians and the broader health care community. In particular, the law provided:
- $100 billion to physicians and hospitals that are experiencing revenue losses and non-reimbursable expenses as a result of COVID-19 and for personal protective equipment (PPE), testing supplies, increased workforce training, emergency operation centers and more;
- $150 billion to states and localities for COVID-19 response activities; and
- $377 billion in financial relief to small businesses, including pediatric practices.
Centers for Medicare & Medicaid Services Chief Seema Verma shared that pediatric practices and children's hospitals can expect to see financial relief in the second round of the provider relief fund (the $100 billion mentioned above). In mid-April, the U.S. Department of Health and Human Services announced who is eligible for the first $30 billion in payments, and at press time, the plan for the second tranche of funding was not yet announced.
In addition to this funding, the CARES Act made significant increases to unemployment insurance and direct payments to working Americans who make up to $75,000 (as an individual) and $150,000 (as a married couple). It also included several important provisions on student loan flexibility, which will benefit medical students, as well as COVID-19 testing and vaccination coverage.
Unrelated to coronavirus response, the law included two longstanding AAP advocacy priorities: over-the-counter drug reform and the reauthorization of the Pediatric Subspecialty Loan Repayment Program.
As these laws are implemented, the Academy will work to ensure policies impacting children, families and pediatricians are executed effectively across the states and without delay.
While the laws offered much needed momentum to address COVID-19 rapidly, the work is far from over. There are several areas where the AAP is urging federal leaders to act.
Some of these priorities include addressing PPE shortages, financial relief for physicians and their practices, and stronger federal leadership on Medicaid, telehealth, vaccines, testing and other core components of pediatric care. The AAP is calling on leaders to ensure response efforts at all levels of government account for children's special needs, including youths involved in the justice system, children in the child welfare system and children in immigrant families.
To further amplify priorities for government response, the AAP has joined with partner organizations in the medical community to call on lawmakers to take necessary action on several health issues.