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A Review of Biden’s American Rescue Plan and Its Impact for Senior Living

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Last night, President-elect Biden released his proposed $1.9 trillion relief package that includes $415 billion focused on combating the COVID-19 pandemic, over $1 trillion in direct aid to individuals and families, and $440 billion in assistance to businesses.

The plan is sweeping and proposes large-scale spending items such as $1,400 in additional stimulus checks, an extension for key unemployment benefits, a federal minimum wage increase, as well as $20 billion for a national vaccination program and $50 billion to scale up coronavirus testing. However, the proposal fails to provide specific details on relief to senior living communities, who have struggled to gain sufficient federal relief dollars and appropriate deployment of vaccines.

At this time, it is expected this proposal will be the base of negotiations for a new COVID relief package in new 117th Congress. It is anticipated that Congress will include many of the items in the President-elect’s plan, however, they will likely use the CARES Act as the base bill to build upon by extending certain provisions and/or adding additional funding to other programs.

Bipartisan support will be needed for passage, so expect the $1.9 trillion proposal to likely be trimmed down to around $1 trillion – a number closer to previously debated congressional proposals. At this date, passage of a bill is targeted for late March or early April.

Argentum supports the concept of bill large enough to provide appropriate resources to both fight the pandemic and provide relief to our frontline workers, operators, and residents who have unfortunately have not been sufficiently prioritized in past relief bills. In general, we can expect more relief dollars, but also potential federal oversight and regulation.

The Biden plan includes a provision that protects “vulnerable populations in congregate settings.” In general, the proposal calls for funding for states to deploy strike teams to long-term care facilities experiencing COVID-19 outbreaks—which may impede vaccination of residents and workers—and to conduct better infection prevention and control oversight. The plan recognizes that “long-term care residents and workers account for almost 40% of all U.S. COVID-19 deaths. Further, African-American and Latina women, who have borne the brunt of the pandemic, are overrepresented among long-term care workers.”

Additionally, President-elect Biden is calling on Congress to authorize the Occupational Safety and Health Administration (OSHA) to issue a COVID-19 Protection Standard that covers a broad set of workers, “so that workers not typically covered by OSHA, like many public workers on the frontlines, also receive protection from unsafe working conditions and retaliation.” The proposal also calls on Congress to provide additional funding for OSHA enforcement and grant funding.

Other key sections of the Biden proposal include:

  • Vaccinations – Invests $20B in a national COVID-19 vaccination program in partnership with states, localities, Tribes, and territories.
  • Expanded Testing – Invests $50B in COVID-19 testing, providing funds for rapid tests and expanded lab capacity.
  • Pandemic Supplies – Invests $30B into the FEMA Disaster Relief Fund to ensure sufficient supplies and protective gear and $10B to expand domestic manufacturing of supplies.
  • Treatments – Supports development, manufacturing, and purchase of COVID-19 therapies, and studies long-term health impacts.
  • Health Insurance – Subsidizes continuation health coverage (COBRA) through the end of September, and expands and increases the value of Premium Tax Credit to lower/eliminate premiums and ensure enrollees won’t pay more than 8.5% of income for coverage.
  • Public Health Jobs – Funds 100,000 public health workers, nearly tripling the country’s community health roles, for vaccine outreach and contact tracing near-term. (Note: Staff chatter is that this will largely try and build off the Census employment model.)
  • Health Disparities – Funding to provide health services for underserved populations, including expanding Community Health Centers and investing in health services on tribal lands.
  • Vulnerable Populations in Congregate Settings – Provides funding for states to deploy strike teams to long-term care facilities experiencing COVID-19 outbreaks. Provides funding for COVID-19 mitigation and vaccination of incarcerated people/staff.
  • Emerging Strains of COVID-19 – Funding to increase sequencing, surveillance, and outbreak analytics capacity.
  • Miscellaneous – Expands access to behavioral health services via $4B to SAMHSA and HRSA and $20B to ensure adequate funding for veterans’ health.