$3 Trillion Stimulus Package Passes out of House, and Transparency Rule May be Back

GOP senators are not likely to support another bipartisan coronavirus recovery bill. 

The U.S. House of Representatives flew into town last Friday and passed a $3 trillion stimulus package, called the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, on mostly partisan lines. You might say that the bill has a little of everything, but at $3 trillion, it’s more accurate to say it has a lot of everything:

• Nearly a trillion dollars for state and local governments and schools;
• Another $100 billion for hospitals and other providers;
• A $200 billion “heroes fund” that would provide hazard pay for essential workers;
• More direct payments to Americans – the methodology is a little different this time, dependents are a part of the calculation, so it could add up to $6,000 for some households;
• More tax breaks for both businesses and individuals;
• Support for farm, food, and nutrition workforces, and support for households in terms of mortgage, rent, and student loans;
• Pension support, assistance for the U.S. Postal Service, expanding broadband access, help for carrying out the elections, help for carrying out the U.S. Census, and funds for just about every federal government agency to support programs that deal with managing all of COVID-19’s social, economic, and health impacts; and
• More funds put into testing and existing stimulus programs, and money would also be provided to shore up the medical supply chain and country’s medical stockpile.

All but one House Republican and a handful of House Democrats voted against the HEROES Act, and Senate Republicans appear wholly against it, at least for the time being. Republicans point out provisions that they think don’t belong in a COVID-19 stimulus package, including reductions in immigration enforcement, money for the Postal Service, and a national requirement to hold elections by mail.

This week, in fact, the Senate plans to ignore the HEROES Act, focusing instead on confirming nominees for positions in the Administration.

The White House seems to be siding with the Senate for the time being, but there are some reports that President Trump would support sending direct payments to individual households again.

The Senate, and Republicans in general, would also very much like to see some legislation on business liability immunity – the idea being that there would be some protection against lawsuits from employees who may be infected while at work for companies that followed government and public health guidelines while reopening.

In terms of healthcare-specific elements, the HEROES Act also provides:

• Free coverage of COVID-19 testing, retroactive to the beginning of the public health emergency, for all patients, regardless of their coverage; and
• No cost sharing for COVID-19

While we’re on the subject of healthcare costs, the Trump Administration really wants to see the rates that hospitals have negotiated with plans. As you may recall, the Centers for Medicare & Medicaid Services (CMS) published a final transparency rule at the end of last year, requiring hospitals to publish their standard rates, including specific negotiated rates. A group of hospitals sued the administration earlier this year over the requirement, and, at the beginning of May, asked a judge to throw the rule out.

Then, last week, CMS snuck a similar requirement into its annual Inpatient Prospective Payment System (IPPS) proposed rule, requiring hospitals to report their median commercial payment rates.

Finally, the word on the street is that President Trump wants the next congressional stimulus package to include that same requirement that hospitals and plans publish their negotiated rates. If Congress passed a bill with the provision in it, then the requirement would be in statute, giving it a lot more authority, such that it would likely beat any lawsuits.

It may seem odd that the Administration is pushing so hard for transparency in the midst of a pandemic, when hospitals are struggling, but the Administration believes strongly that this one requirement would completely change how the business of healthcare is conducted in this country.

Programming Note: Matthew Albright is a permanent panelist on Monitor Mondays. Listen to his live “Legislative Updates,” sponsored by Zelis, every Monday, 10 a.m. EST.